{"id":8226,"date":"2020-09-10T15:58:02","date_gmt":"2020-09-10T20:58:02","guid":{"rendered":"https:\/\/cornflowerblue-rail-980953.hostingersite.com\/?p=8226"},"modified":"2020-09-10T15:58:02","modified_gmt":"2020-09-10T20:58:02","slug":"whats-new-in-pediatric-imaging-turkish-september-2020","status":"publish","type":"post","link":"https:\/\/staging-hub.acoredu.com\/tr\/whats-new-in-pediatric-imaging-turkish-september-2020\/","title":{"rendered":"What\u2019s new in Pediatric Imaging (Turkish) \u2013 September 2020"},"content":{"rendered":"<h3><span style=\"color: #800080;\"><strong>ABDOM\u0130NAL G\u00d6RNT\u00dcLEME<\/strong><\/span><\/h3>\n<p>&nbsp;<\/p>\n<h5><span style=\"color: #3366ff;\"><strong>Apandisit te\u015fhisinde ultrasonun tan\u0131sal do\u011frulu\u011fundaki de\u011fi\u015fikliklerin de\u011ferlendirmesi: Pratik yapmak m\u00fckemmelle\u015ftirir mi?<\/strong><\/span><\/h5>\n<p>Austin-Page LR, Pham PK, and Elkhunovich M. Evaluating changes in diagnostic accuracy of ultrasound for appendicitis: does practice make perfect? Article in Press.<\/p>\n<p><em>J Emerg Med<\/em> 2020; 1\u201310<\/p>\n<p><a href=\"https:\/\/doi.org\/10.1016\/j.jemermed.2020.06.001\">https:\/\/doi.org\/10.1016\/j.jemermed.2020.06.001<\/a>.<\/p>\n<p><strong>Soru: <\/strong>Ultrason ilk protokol\u00fcn\u00fcn benimsenmesinden sonra apandisit i\u00e7in ultrasonun tan\u0131sal do\u011frulu\u011fundaki zamanla olan de\u011fi\u015fiklikler nelerdir?<\/p>\n<p><strong>\u00c7al\u0131\u015fma Tasar\u0131s\u0131: <\/strong>2009&#8217;dan 2014&#8217;e kadar geriye d\u00f6n\u00fck inceleme<\/p>\n<p><strong>Merkez: <\/strong>Tek Merkez, California \u00dcniversitesi-San Diego \/ Rady \u00c7ocuk Hastanesi (Acil Servis hacmi y\u0131lda &gt; 70.000 hasta ziyareti ile kentsel, ba\u011f\u0131ms\u0131z \u00e7ocuk hastanesi)<\/p>\n<p><strong>Kat\u0131l\u0131mc\u0131lar: <\/strong>1058 ultrason muayenesi dahil edildi ve incelendi.<\/p>\n<p><strong>M\u00fcdahele: <\/strong>Acil servise kar\u0131n a\u011fr\u0131s\u0131 ile ba\u015fvuran \u00e7ocuklarda birincil g\u00f6r\u00fcnt\u00fcleme y\u00f6ntemi olarak ultrason uygulamas\u0131<\/p>\n<p><strong>\u00c7\u0131kt\u0131: <\/strong>Birincil sonu\u00e7lar, kesinle\u015fmi\u015f bir rapora (tamamen g\u00f6rselle\u015ftirilmi\u015f normal apandiks veya kesin apandisit) veya \u015f\u00fcpheli bir rapora (raporda apandisitten bahsedilmeden g\u00f6rselle\u015ftirilmemi\u015f veya k\u0131smen g\u00f6rselle\u015ftirilmi\u015f apandiks) dayanan ultrasonun zaman i\u00e7inde do\u011fruluk oranlar\u0131yd\u0131. Do\u011fruluk oranlar\u0131 ayr\u0131ca hastan\u0131n cinsiyeti, v\u00fccut kitle indeksi (BMI) ve ultrasonografi uzman\u0131n\u0131n deneyimi ile ili\u015fkili olarak analiz edildi. \u0130kincil sonu\u00e7lar, apandisit i\u00e7in ultrasonun duyarl\u0131l\u0131\u011f\u0131 ve \u00f6zg\u00fcll\u00fc\u011f\u00fcyd\u00fc.<\/p>\n<p><strong>Ana Sonu\u00e7lar<\/strong>: Ultrasonun apandisit i\u00e7in tan\u0131sal do\u011frulu\u011fu, 5 y\u0131ldan fazla bir s\u00fcredir % 24.5&#8217;lik bir genel do\u011frulukla % 13.9&#8217;dan % 31.5&#8217;e (P = 0.001) \u00f6nemli \u00f6l\u00e7\u00fcde artm\u0131\u015ft\u0131r. Genel duyarl\u0131l\u0131k ve \u00f6zg\u00fcll\u00fck s\u0131ras\u0131yla % 80,7 ve % 77,6\u2019idi. Erkek \u00e7ocuklar kesin raporlarla \u00f6nemli \u00f6l\u00e7\u00fcde ili\u015fkiliydi (P &lt;0.001) ve daha y\u00fcksek v\u00fccut kitle indeksi \u015f\u00fcpheli raporlarla \u00f6nemli \u00f6l\u00e7\u00fcde ili\u015fkilendirildi (P &lt;0.001). Ultrasonografi uzman\u0131 deneyimi, kesin raporlarla ili\u015fkili de\u011fildi (P = 0.22).<\/p>\n<p><strong>Yorum: <\/strong>\u00c7ocuklarda apandisitin de\u011ferlendirilmesi i\u00e7in \u00e7o\u011fu enstit\u00fcde ilk olarak ultrason ile g\u00f6r\u00fcnt\u00fclemeye ba\u015fvurulur ama hala ilk basamak olarak BT kullanan bir\u00e7ok enstit\u00fc de mevcuttur. Bu \u00e7al\u0131\u015fma, ultrasonun do\u011frulu\u011funun zaman i\u00e7inde geli\u015fti\u011fini ve bunun da daha bir\u00e7ok kurumu ultrasonu ba\u015flang\u0131\u00e7 y\u00f6ntemi olarak benimsemeye te\u015fvik edebilece\u011fini g\u00f6stermektedir. Ne yaz\u0131k ki bu \u00e7al\u0131\u015fma, g\u00f6rselle\u015ftirilmemi\u015f veya k\u0131smen g\u00f6rselle\u015ftirilmi\u015f apandiksi belirsiz olarak s\u0131n\u0131fland\u0131r\u0131rken \u00e7o\u011fu ara\u015ft\u0131rma, g\u00f6rselle\u015ftirilmemi\u015f apandiksi normal olarak tan\u0131mlamaktad\u0131r. Kategorizasyondaki bu fark, apandisit te\u015fhisinde ultrasonun bildirilen do\u011frulu\u011funu \u00f6nemli \u00f6l\u00e7\u00fcde art\u0131r\u0131r.<\/p>\n<p>&nbsp;<\/p>\n<h5><span style=\"color: #3366ff;\"><strong>Bilgisayarl\u0131 tomografide \u00e7ocuklarda abdominal lenf nodu boyutu<\/strong><\/span><\/h5>\n<p>Spijkers S, Staats J.M., Littooij A.S.\u00a0et al.\u00a0Abdominal lymph node size in children at computed tomography.<\/p>\n<p><em>Pediatr Radiol<\/em> 2020;\u00a050,\u00a01263\u20131270.<\/p>\n<p><a href=\"https:\/\/doi.org\/10.1007\/s00247-020-04715-z\">https:\/\/doi.org\/10.1007\/s00247-020-04715-z<\/a>.<\/p>\n<p><strong>Soru: <\/strong>BT&#8217;de \u00e7ocuklarda abdominal lenf nodlar\u0131n\u0131n normal boyutu nedir?<\/p>\n<p><strong>\u00c7al\u0131\u015fma Tasar\u0131s\u0131: <\/strong>2012&#8217;den 2014&#8217;e kadar geriye d\u00f6n\u00fck \u00e7al\u0131\u015fma<\/p>\n<p><strong>Merkez: <\/strong>Tek merkez (Utrecht \u00dcniversitesi T\u0131p Merkezi \/ Wilhelmina \u00c7ocuk Hastanesi, Utrecht, Hollanda)<\/p>\n<p><strong>Kat\u0131l\u0131mc\u0131lar: <\/strong>Y\u00fcksek enerjili travma sonras\u0131 kontrastl\u0131 BT uygulanan 1-17 ya\u015f aras\u0131 bunun d\u0131\u015f\u0131nda sa\u011fl\u0131kl\u0131 152 \u00e7ocuk.<\/p>\n<p><strong>\u00c7\u0131kt\u0131: <\/strong>Maksimum boyut, ortalama de\u011ferler ve normal referans aral\u0131\u011f\u0131n\u0131n \u00fcst s\u0131n\u0131rlar\u0131 dahil olmak \u00fczere ya\u015f ve istasyon ba\u015f\u0131na lenf nodu \u00f6l\u00e7\u00fcmleri. Yeti\u015fkin RECIST (Solid t\u00fcm\u00f6rlerde yan\u0131t de\u011ferlendirme kriterleri) kriterleri referans olarak kullan\u0131lm\u0131\u015ft\u0131r.<\/p>\n<p><strong>Ana Sonu\u00e7lar: <\/strong>152 hastan\u0131n her biri i\u00e7in en az 3 lenf nodu istasyonu aksiyal ve koronal d\u00fczlemde toplam 647 lenf nodu \u00f6l\u00e7\u00fcld\u00fc. En s\u0131k tespit edilen nodlar inguinal (% 100), mezenterik (% 99) ve iliak (% 98) lenf nodlar\u0131yd\u0131. T\u00fcm lenf nodu istasyonlar\u0131n\u0131n k\u0131sa aksiyal ekseninin \u00fcst s\u0131n\u0131rlar\u0131 (istatistiksel yeniden \u00f6rnekleme ile belirlenir) mevcut yeti\u015fkin k\u0131lavuzlar\u0131na benzerdi (&lt;10 mm) ve 6,4-10 mm aral\u0131\u011f\u0131ndayd\u0131. K\u0131sa koronal eksen, inguinal (12.4 mm) ve mezenterik istasyonlar (11.2 mm) i\u00e7in referans aral\u0131\u011f\u0131ndan fazlayd\u0131. Yeti\u015fkin RECIST (Solid t\u00fcm\u00f6rlerde yan\u0131t de\u011ferlendirme kriterleri) kriterleri kullan\u0131ld\u0131\u011f\u0131nda, \u00e7ocuklar\u0131n % 19&#8217;unda bir veya daha fazla b\u00fcy\u00fcm\u00fc\u015f lenf nodu (a\u011f\u0131rl\u0131kl\u0131 olarak inguinal) olacakt\u0131. T\u00fcm istasyonlar i\u00e7in ya\u015f ve lenf nodu boyutu aras\u0131nda istatistiksel olarak anlaml\u0131 pozitif korelasyon vard\u0131 (0.21-0.5, P &lt;0.05).<\/p>\n<p><strong>Yorum:<\/strong> Bu \u00e7al\u0131\u015fma, \u00e7ocuklarda abdominal ve pelvik lenf nodu boyutlar\u0131 i\u00e7in normatif veriler sa\u011flamaktad\u0131r. Yazarlar hem k\u0131sa hem de uzun aksiyal ve koronal \u00f6l\u00e7\u00fcmler i\u00e7in de\u011ferler sa\u011flad\u0131lar. Genel olarak, koronal uzun eksen en geni\u015f g\u00fcven aral\u0131\u011f\u0131na (CI) sahiptir ve RECIST (Solid t\u00fcm\u00f6rlerde yan\u0131t de\u011ferlendirme kriterleri) kriterlerine uygulanamaz. Bu nedenle, k\u0131sa eksen aksiyal aral\u0131klar daha iyi bir referans se\u00e7ene\u011fini temsil eder.<\/p>\n<p>&nbsp;<\/p>\n<h5><span style=\"color: #3366ff;\"><strong>Ultrasonografi kullanarak pediatrik ileokolik intusepsiyonu ince ba\u011f\u0131rsak intusepsiyonundan do\u011fru \u015fekilde ay\u0131rt etme<\/strong><\/span><\/h5>\n<p>Zhang M, Zhou X, Hu Q, et al. Accurately distinguishing pediatric ileocolic intussusception from small-bowel intussusception using ultrasonography<em>. <\/em><\/p>\n<p><em>J Pediatr Surg<\/em> 2020.<\/p>\n<p><a href=\"https:\/\/doi.org\/10.1016\/j.jpedsurg.2020.06.014\">https:\/\/doi.org\/10.1016\/j.jpedsurg.2020.06.014<\/a>.<\/p>\n<p><strong>Soru: <\/strong>Ultrason, ileokolik ve ince ba\u011f\u0131rsak intusepsiyonlar\u0131 aras\u0131nda ayr\u0131m yapabilir mi?<\/p>\n<p><strong>Tasar\u0131: <\/strong>2018&#8217;den 2020&#8217;ye kadar geriye d\u00f6n\u00fck \u00e7al\u0131\u015fma<\/p>\n<p><strong>Merkez:<\/strong> Tek merkez (Changsha Merkez Hastanesi, Hunan, \u00c7in)<\/p>\n<p><strong>Kat\u0131l\u0131mc\u0131lar: <\/strong>123 ince barsak intususepsiyon vakas\u0131 ve 60 ileokolik intusepsiyon vakas\u0131 olmak \u00fczere toplam 183 intususepsiyonlu hasta.<\/p>\n<p><strong>\u00c7\u0131kt\u0131:<\/strong> Lezyon \u00e7ap\u0131, merkezi ya\u011f kal\u0131nl\u0131\u011f\u0131 (fat core thickness), d\u0131\u015f duvar kal\u0131nl\u0131\u011f\u0131, intususepsiyon uzunlu\u011fu, lenf d\u00fc\u011f\u00fcmlerinin veya s\u00fcr\u00fckleyici nokta (lead point) varl\u0131\u011f\u0131 ve ileo\u00e7ekal b\u00f6lgenin g\u00f6r\u00fcn\u00fcm\u00fc dahil olmak \u00fczere kar\u015f\u0131la\u015ft\u0131rmal\u0131 ultrason \u00f6l\u00e7\u00fcmleri.<\/p>\n<p><strong>Ana Sonu\u00e7lar: <\/strong>\u0130leokolik invajinasyon i\u00e7in ortalama \u00e7ap 28.9 mm, merkezi ya\u011f kal\u0131nl\u0131\u011f\u0131 11.4 mm, d\u0131\u015f duvar kal\u0131nl\u0131\u011f\u0131 6.5 mm, lezyon uzunlu\u011fu 53.4 mm ve 56\/60 g\u00f6r\u00fcn\u00fcr lenf nodlar\u0131 vard\u0131. \u0130leo\u00e7ekal b\u00f6lge normal g\u00f6r\u00fcnen hi\u00e7bir vaka yoktu ve sadece 5 \/ 60&#8217;\u0131nda (% 8) normal g\u00f6r\u00fcnen bir \u00e7\u0131kan kolon vard\u0131. \u0130nce ba\u011f\u0131rsak intussusepsiyonu i\u00e7in ortalama \u00e7ap 15,8 mm, merkezi ya\u011f kal\u0131nl\u0131\u011f\u0131 2,5 mm, d\u0131\u015f duvar kal\u0131nl\u0131\u011f\u0131 3,8 mm, lezyon uzunlu\u011fu 27,6 mm ve sadece 1 vakada lenf nodlar\u0131 g\u00f6r\u00fclebilirdi. 104\/123 vakada (% 85) normal g\u00f6r\u00fcnen ileo\u00e7ekal b\u00f6lge ve 120\/123 vakada (% 98) normal \u00e7\u0131kan bir kolon vard\u0131. Bu farkl\u0131l\u0131klar\u0131n t\u00fcm\u00fc, P &lt;0.001 ile istatistiksel olarak anlaml\u0131yd\u0131.<\/p>\n<p><strong>Yorum:<\/strong> \u0130leokolik ve ince ba\u011f\u0131rsak intususepsiyonu, \u00e7ocuklarda en s\u0131k g\u00f6r\u00fclen intususepsiyon tipleridir ancak tedavileri farkl\u0131d\u0131r. \u0130leokolik intususepsiyon, iskemi, nekroz ve perforasyona yol a\u00e7abilir bu nedenle derhal m\u00fcdahele edilmelidir. \u00c7o\u011fu ince ba\u011f\u0131rsak intussusepsiyonu ge\u00e7icidir ve konservatif olarak y\u00f6netilebilir. Bu makale, ultrasonun incelenen parametrelere g\u00f6re ince ba\u011f\u0131rsak ve ileokolik intusepsiyon aras\u0131nda ayr\u0131m yapabildi\u011fini g\u00f6stermektedir. \u0130leo\u00e7ekal b\u00f6lge ve \u00e7\u0131kan kolonun normal ultrason g\u00f6r\u00fcn\u00fcm\u00fc, ileokolik ve ince ba\u011f\u0131rsak intusepsiyonunu ay\u0131rt etmek i\u00e7in en iyi bulgu olabilir.<\/p>\n<p>&nbsp;<\/p>\n<h3><span style=\"color: #800080;\"><strong>TORAKS G\u00d6R\u00dcNT\u00dcLEME<\/strong><\/span><\/h3>\n<p>&nbsp;<\/p>\n<h5><span style=\"color: #3366ff;\"><strong>\u00c7ocuklarda Coronavirus hastal\u0131\u011f\u0131 2019 (COVID-19): G\u00f6r\u00fcnt\u00fcleme bulgular\u0131n\u0131n sistematik bir incelemesi.<\/strong><\/span><\/h5>\n<p>Shelmerdine SC, Lovrenski J, Caro-Dominguez P et al. Coronavirus disease 2019 (COVID-19) in children: a systematic review of imaging findings. Published online: 18 June 2020.<\/p>\n<p><em>Pediatr Radiol<\/em>.<\/p>\n<p><a href=\"https:\/\/doi.org\/10.1007\/s00247-020-04726-w\">https:\/\/doi.org\/10.1007\/s00247-020-04726-w<\/a>.<\/p>\n<p><strong>Soru: <\/strong>Pediatrik COVID-19 vakalar\u0131nda g\u00f6r\u00fcnt\u00fcleme bulgular\u0131 nelerdir?<\/p>\n<p><strong>Tasar\u0131: <\/strong>4 veritaban\u0131n\u0131n (Medline, Embase, Cochrane, Google Scholar) 5 y\u0131l boyunca sistematik incelemesi<\/p>\n<p><strong>Merkez: <\/strong>\u00c7in, G\u00fcney Kore ve \u0130ran<\/p>\n<p><strong>Makaleler: <\/strong>22 makale dahil edildi (431 \u00e7ocukta toraks g\u00f6r\u00fcnt\u00fcleme bulgular\u0131)<\/p>\n<p><strong>M\u00fcdahele: <\/strong>Toraks g\u00f6r\u00fcnt\u00fcleme (IV kontrastl\u0131 veya kontrasts\u0131z toraks BT, akci\u011fer radyografileri)<\/p>\n<p><strong>\u00c7\u0131kt\u0131: <\/strong>\u0130lk g\u00f6r\u00fcnt\u00fcleme bulgular\u0131, takip g\u00f6r\u00fcnt\u00fcleme bulgular\u0131 (3-15 g\u00fcn sonra).<\/p>\n<p><strong>Ana Sonu\u00e7lar:<\/strong> Toraks BT yap\u0131lan hastalar\u0131n % 34&#8217;\u00fcnde ba\u015flang\u0131\u00e7ta normal bulgular vard\u0131. Anormallikler en s\u0131k alt loblarda ve tek tarafl\u0131 g\u00f6r\u00fcld\u00fc. En yayg\u0131n g\u00f6r\u00fcnt\u00fcleme paterni buzlu cam opasiteleriydi (% 62.4). Plevral ef\u00fczyonlar nadirdi ve hi\u00e7bir vakada lenfadenopati g\u00f6r\u00fclmedi. Takip edilen g\u00f6r\u00fcnt\u00fclemelerde % 29 iyile\u015fme g\u00f6sterdi, % 25 normal kald\u0131 ve % 9 ilerleme g\u00f6sterdi.<\/p>\n<p><strong>Yorum:<\/strong> Bu, zaman\u0131nda yap\u0131lm\u0131\u015f COVID-19&#8217;lu pediyatrik hastalarda kar\u015f\u0131la\u015f\u0131lan yayg\u0131n g\u00f6\u011f\u00fcs g\u00f6r\u00fcnt\u00fcleme bulgular\u0131n\u0131 g\u00f6steren bir \u00e7al\u0131\u015fmad\u0131r. Yazarlar, ba\u011f\u0131\u015f\u0131kl\u0131\u011f\u0131 zay\u0131flam\u0131\u015f \u00e7ocuklar\u0131n de\u011ferlendirilmesindeki bo\u015fluklar ve grubun esas olarak \u00c7in&#8217;den oldu\u011fu ger\u00e7e\u011fi dahil olmak \u00fczere \u00e7e\u015fitli s\u0131n\u0131rlamalar\u0131 kabul etmektedirler. COVID-19 5 y\u0131ldan daha az bir s\u00fcredir bilinmesine ra\u011fmen, yazarlar muhtemelen eksiksizlik i\u00e7in 5 y\u0131l boyunca bir literat\u00fcr taramas\u0131 yapt\u0131lar. \u00c7al\u0131\u015fmalar\u0131, ilk literat\u00fcr taramas\u0131 sonras\u0131 2 ek literat\u00fcr taramas\u0131 ve gri literat\u00fcr\u00fcnde eklenmesiyle tan\u0131nm\u0131\u015ft\u0131r. Bu makale COVID-19&#8217;un ekstra torasik g\u00f6r\u00fcnt\u00fcleme bulgular\u0131n\u0131 ele almamaktad\u0131r.<\/p>\n<p>&nbsp;<\/p>\n<h5><span style=\"color: #3366ff;\"><strong>Pediyatrik pop\u00fclasyonda e-sigara veya elektronik sigara \u00fcr\u00fcn\u00fc kullan\u0131m\u0131na ba\u011fl\u0131 akci\u011fer hasar\u0131: sunumda g\u00f6r\u00fcnt\u00fcleme \u00f6zellikleri<\/strong> <strong>ve k\u0131sa vadeli takip<\/strong><\/span><\/h5>\n<p>Wang KY, Jadhav SP, Yenduri NJS\u00a0<em>et al<\/em>.\u00a0E-cigarette or vaping product use-associated lung injury in the pediatric population: imaging features at presentation and short-term follow-up.<\/p>\n<p><em>Pediatr Radiol\u00a0<\/em>2020; 50,\u00a01231\u20131239.<\/p>\n<p><a href=\"https:\/\/doi.org\/10.1007\/s00247-020-04698-x\">https:\/\/doi.org\/10.1007\/s00247-020-04698-x<\/a>.<\/p>\n<p><strong>Soru: <\/strong>BT&#8217;de e-sigara veya t\u00fcrevleri \u00fcr\u00fcn kullan\u0131m\u0131na ba\u011fl\u0131 akci\u011fer hasar\u0131n\u0131n (EVALI) en yayg\u0131n g\u00f6r\u00fcnt\u00fcleme bulgular\u0131 nelerdir?<\/p>\n<p><strong>Tasar\u0131<\/strong>: Geriye d\u00f6n\u00fck inceleme<\/p>\n<p><strong>Merkez<\/strong>: Tek merkez (Baylor T\u0131p Fak\u00fcltesi \/ Texas \u00c7ocuk Hastanesi, Houston, TX)<\/p>\n<p><strong>Kat\u0131l\u0131mc\u0131lar<\/strong>: Do\u011frulanm\u0131\u015f veya muhtemel EVALI (e-cigarette or vaping products associated lung injury) olan 11 gen\u00e7<\/p>\n<p><strong>\u00c7\u0131kt\u0131:<\/strong> Normal veya anormal akci\u011fer grafisi; BT g\u00f6r\u00fcnt\u00fcleme bulgular\u0131, \u00f6zellikle peri-bronkovask\u00fcler korunma, subplevral korunma, lob\u00fcler korunma, yer\u00e7ekimine ba\u011fl\u0131 opasitelerin gradyan\u0131, konsolidasyon, buzlu cam opasiteleri, nod\u00fcller, interlob\u00fcler septal kal\u0131nla\u015fma, arnavut kald\u0131r\u0131m\u0131 g\u00f6r\u00fcn\u00fcm\u00fc, kistler, mimari bozulma veya bal pete\u011fi g\u00f6r\u00fcn\u00fcm\u00fc, bron\u015fiyal duvar kal\u0131nla\u015fmas\u0131, bron\u015fektazi, plevral ef\u00fczyon, pn\u00f6motoraks, perikardiyal ef\u00fczyon, pn\u00f6momediastinum ve hiler veya mediastinal lenfadenopati. G\u00f6zlemciler aras\u0131 uyum da uyguland\u0131.<\/p>\n<p><strong>Ana Sonu\u00e7lar:<\/strong> Ba\u015fvuru s\u0131ras\u0131ndaki ya\u015f ortancas\u0131 15,7 idi. 9 erkek ve 2 k\u0131z vard\u0131. T\u00fcm hastalarda ate\u015f ve bulant\u0131 ve\/veya kusma vard\u0131. Nefes darl\u0131\u011f\u0131 yaln\u0131zca 5\/11 vakada bir vard\u0131 ve 6\/11&#8217;inde semptom \u00f6ks\u00fcr\u00fckt\u00fc. Ba\u015fvuru an\u0131nda t\u00fcm hastalar\u0131n 10\/11&#8217;i anormal akci\u011fer grafisine sahipti. Hepsi anormal olan 9 olguda toraks BT\u2019si \u00e7ekildi. BT&#8217;de en s\u0131k g\u00f6r\u00fclen bulgular buzlu cam opasiteleri (9\/9), interlob\u00fcler septal \u00e7izgi kal\u0131nla\u015fmas\u0131 (8\/9), subplevral koruma (8\/9), kald\u0131r\u0131m ta\u015f\u0131 paterni (crazy paving) (8\/9), lenfadenopati (7\/9) ve konsolidasyonlard\u0131r (6\/9). G\u00f6r\u00fcnt\u00fcleme bulgular\u0131nda tam veya tama yak\u0131n \u00e7\u00f6z\u00fcn\u00fcrl\u00fck, k\u0131sa s\u00fcreli takipte 5\/6 vakada kaydedildi (medyan 114 g\u00fcn).<\/p>\n<p><strong>Yorum:<\/strong> Bildirilen EVALI vakalar\u0131, 2019&#8217;da 2.807 vaka ve \u015eubat 2020&#8217;ye kadar bildirilen 68 \u00f6l\u00fcmle zirve yapt\u0131. Bu \u00e7al\u0131\u015fma, gen\u00e7lerde EVALI&#8217;nin yayg\u0131n BT bulgular\u0131n\u0131n buzlu cam opasitelerini, interlob\u00fcler septal \u00e7izgi kal\u0131nla\u015fmas\u0131n\u0131 ve subplevral koruyucu ve lenfadenopatili kald\u0131r\u0131m ta\u015f\u0131 paternini i\u00e7erdi\u011fini bildirmektedir. Bu bulgular belirli bir akci\u011fer hasar\u0131 modeline uymad\u0131\u011f\u0131ndan, yak\u0131n zamanda elektronik sigara kullan\u0131m\u0131n\u0131n klinik \u00f6yk\u00fcs\u00fc ve\/veya bulgular i\u00e7in ba\u015fka a\u00e7\u0131klamalar\u0131n olmamas\u0131 tan\u0131da anahtar rol oynar. \u00d6zellikle ate\u015f ve gastrointestinal semptomlar, solunum semptomlar\u0131ndan daha yayg\u0131nd\u0131. Bu bulgular, yeti\u015fkinlerdeki EVALI bulgular\u0131 ile ilgili literat\u00fcr ile tutarl\u0131 olsa da, \u00f6rneklemin k\u00fc\u00e7\u00fck olmas\u0131 ve patolojik korelasyonun olmamas\u0131 s\u0131n\u0131rlamalard\u0131r.<\/p>\n<p>&nbsp;<\/p>\n<h3><span style=\"color: #800080;\"><strong>KAS-\u0130SKELET S\u0130STEM\u0130 RADYOLOJ\u0130S\u0130<\/strong><\/span><\/h3>\n<p>&nbsp;<\/p>\n<h5><strong><span style=\"color: #3366ff;\">Cerrahi Olmayan Pektus Ekskavatum Hastalar\u0131n\u0131n 3D \u0130ndekslerinin De\u011ferlendirilmesi<\/span> <\/strong><\/h5>\n<p>Fuentes S, Pradillos-Serna JM, Berlioz M, et al. Validating 3D indexes in the non-surgical pectus excavatum patient. Article In Press.<\/p>\n<p><em>J Ped Surg<\/em> 2020.<\/p>\n<p><a href=\"https:\/\/doi.org\/10.1016\/j.jpedsurg.2020.06.006\">https:\/\/doi.org\/10.1016\/j.jpedsurg.2020.06.006<\/a>.<\/p>\n<p><strong>Soru: <\/strong>Farkl\u0131 \u015fiddet derecelerindeki (hafif, orta, \u015fiddetli) pektus ekskavatum (PE) hastalar\u0131ndan ta\u015f\u0131nabilir bir 3D taray\u0131c\u0131 ile elde edilen \u00f6l\u00e7\u00fcmlerin do\u011frulu\u011fu ve g\u00fcvenilirli\u011fi nedir?<\/p>\n<p><strong>Tasar\u0131m:<\/strong> Prospektif, kesitsel \u00e7al\u0131\u015fma<\/p>\n<p><strong>Merkez:<\/strong> Tek merkez; Servicio de Cirugi\u0301a Pedia\u0301trica, Complejo Asistencial Universitario de Leo\u0301n, \u0130spanya<\/p>\n<p><strong>Kat\u0131l\u0131mc\u0131lar:<\/strong> 28 \u00e7ocuk (PE hastas\u0131 21 \u00e7ocuk ve hasta olmayan 7 \u00e7ocuk (kontrol grubu))<\/p>\n<p><strong>M\u00fcdahale:<\/strong> Ta\u015f\u0131nabilir el tipi k\u0131z\u0131l\u00f6tesi taray\u0131c\u0131 ve s\u0131n\u0131rl\u0131 MRG (kontrol) kullanarak 3B y\u00fczey g\u00f6r\u00fcnt\u00fcleme<\/p>\n<p><strong>\u00c7\u0131kt\u0131:<\/strong> 3D Haller \u0130ndeksi (3DHI), 3D D\u00fczeltme \u0130ndeksi (3DCI), MRG yoluyla geleneksel CI ve geleneksel HI<\/p>\n<p><strong>Ana Sonu\u00e7lar:<\/strong> Kontrol gruplar\u0131nda 3DHI ve geleneksel HI aras\u0131nda (0.653, P&lt;0.05), 3DCI ve geleneksel CI aras\u0131nda (0.724, P&lt;0.01) istatiksel olarak kayda de\u011fer bir korelasyon tespit edildi. Bunun yan\u0131 s\u0131ra hasta grupta 3DHI ve geleneksel HI aras\u0131nda (0.576, P&lt;0.05), 3DCI ve geleneksel CI aras\u0131nda (0.764, P&lt;0.01) istatiksel olarak kayda de\u011fer bir korelasyon tespit edildi. Hastal\u0131\u011f\u0131n \u015fiddetine ba\u011fl\u0131 olarak geleneksel HI ve CI de\u011ferleri MRG ve 3DCI \u00fczerinde de\u011fi\u015fiklik g\u00f6sterdi (P&lt;0.001). 3DHI de\u011ferleri aras\u0131nda kontrol ve hasta gruplar\u0131 aras\u0131nda \u00f6nemli bir fark g\u00f6zlemlenmedi.<\/p>\n<p><strong>Yorum:<\/strong> Vaka say\u0131s\u0131n\u0131n az olmas\u0131na ra\u011fmen bu \u00e7al\u0131\u015fma y\u00fczey 3D g\u00f6r\u00fcnt\u00fcleme teknolojisinin hastal\u0131\u011f\u0131n \u015fiddetine ba\u011fl\u0131 olmadan geleneksel kesitsel g\u00f6r\u00fcnt\u00fcleme sonu\u00e7lar\u0131yla uyum i\u00e7erisinde oldu\u011funu ortaya koydu. Olumlu \u00f6zellikleri eri\u015filebilirli\u011fin kolayl\u0131\u011f\u0131 ve k\u0131sa tarama s\u00fcresi olan bu teknoloji gelecekteki \u00e7al\u0131\u015fmalarda solunum s\u0131ras\u0131ndaki deformitenin dinamiklerini ve semptomlar\u0131n klinik korelasyonunu incelemek i\u00e7in kullan\u0131labilir. MRG teknolojisine k\u0131yasla 3D y\u00fczey taramas\u0131n\u0131n dezavantaj\u0131 kalp fonksiyonlar\u0131n\u0131 de\u011ferlendirme kabiliyetinin olmamas\u0131d\u0131r.<\/p>\n<p>&nbsp;<\/p>\n<h5><strong><span style=\"color: #3366ff;\">Orak h\u00fccreli anemili gen\u00e7 yeti\u015fkinlerdeki ve \u00e7ocuklardaki osteomiyelitin mikrobiyolojisi ve radyografik \u00f6zellikleri<\/span> <\/strong><\/h5>\n<p>Kao CM,\u00a0Yee ME,\u00a0Maillis A, et\u00a0al.\u00a0Microbiology and radiographic features of osteomyelitis in children and adolescents with sickle cell disease.<\/p>\n<p><em>Pediatr Blood Cancer<\/em>\u00a02020; e28517.<\/p>\n<p><a href=\"https:\/\/doi.org\/10.1002\/pbc.28517\">https:\/\/doi.org\/10.1002\/pbc.28517<\/a><\/p>\n<p><strong>Soru: <\/strong>Orak h\u00fccreli anemili \u00e7ocuklarda g\u00f6r\u00fcnt\u00fcleme bulgular\u0131na g\u00f6re osteomiyeliti tespit etmenin tan\u0131sal olas\u0131l\u0131\u011f\u0131 nedir?<\/p>\n<p><strong>Tasar\u0131m:<\/strong> Retrospektif \u00e7al\u0131\u015fma (2010\u2019dan 2019\u2019a kadar)<\/p>\n<p><strong>Merkez:<\/strong> Tek merkez (Emory University\/Children\u2019s Hospital of Atlanta, Atlanta, GA)<\/p>\n<p><strong>Kat\u0131l\u0131mc\u0131lar: <\/strong>Orak h\u00fccreli anemili 3553 hasta, 19 hastada g\u00f6zlenmi\u015f toplamda 20 vaka (kat\u0131l\u0131mc\u0131lardan biri 2 y\u0131l arayla 2 kere hastal\u0131\u011f\u0131 ge\u00e7irmi\u015f), 20 vakadan yaln\u0131zca 19\u2019u g\u00f6r\u00fcnt\u00fclenmi\u015f.<\/p>\n<p><strong>\u00c7\u0131kt\u0131:<\/strong> Osteomiyelitin g\u00f6r\u00fcnt\u00fclenme kan\u0131t\u0131 ve k\u00fclt\u00fcrle do\u011frulanm\u0131\u015f enfeksiyon<\/p>\n<p><strong>Ana Sonu\u00e7lar:<\/strong> 18 MRG ve 1 BT yap\u0131ld\u0131. Retrospektif olarak bak\u0131ld\u0131\u011f\u0131nda osteomyelitin MRG bulgular\u0131 4\/19 vakada kesin, 10\/19 vakada olas\u0131, 5\/19 vakada ku\u015fkulu olarak raporland\u0131. 9 k\u00fclt\u00fcr pozitif vakan\u0131n MRG bulgular\u0131n\u0131n ikisi kesin, d\u00f6rd\u00fc olas\u0131 ve \u00fc\u00e7\u00fc ku\u015fkulu olarak raporland\u0131. Vakalar\u0131n %58&#8217;inde apse veya s\u0131v\u0131 toplanmas\u0131, %79&#8217;unda kom\u015fu miyozit veya kas \u00f6demi, %63&#8217;\u00fcnde eklem ef\u00fczyonu ve %47&#8217;sinde osteonekroz tespit edildi.<\/p>\n<p><strong>Yorum:<\/strong> Osteomiyelit, orak h\u00fccreli anemili \u00e7ocuklarda kas-iskelet a\u011fr\u0131s\u0131n\u0131n nedenlerinden biridir. Bu \u00e7al\u0131\u015fmada MRG yoluyla osteomiyelit olas\u0131l\u0131\u011f\u0131n\u0131n derecelendirilmesi, osteomiyelit te\u015fhisinde tek ba\u015f\u0131na MRG&#8217;nin yetersizli\u011fini ortaya koymaktad\u0131r. K\u00fclt\u00fcr\u00fc pozitif olan hastalar\u0131n sadece % 22&#8217;sinde MRG bulgular\u0131n\u0131n osteomiyelit i\u00e7in kesin bulgu oldu\u011fu g\u00f6r\u00fcld\u00fc. Bu nedenle, tan\u0131 ve tedavi kararlar\u0131n\u0131 verirken radyolojik, mikrobiyolojik ve klinik i\u015fbirli\u011fine g\u00fc\u00e7l\u00fc bir ihtiya\u00e7 vard\u0131r.<\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<h5><span style=\"color: #3366ff;\"><strong>Pediatrik Pop\u00fclasyondaki Kitlelerin De\u011ferlendirilmesinde Ultrason Kullan\u0131m\u0131.<\/strong><\/span><\/h5>\n<p>LeMoine B and Samet JD. Utility of ultrasound for evaluating masses in the pediatric population. Article In Press.<\/p>\n<p><em>Adv Clin Rad<\/em> 2020.<\/p>\n<p><a href=\"https:\/\/doi.org\/10.1016\/j.yacr.2020.05.001\">https:\/\/doi.org\/10.1016\/j.yacr.2020.05.001<\/a>.<\/p>\n<p><strong>Soru: <\/strong>Ultrasonografinin pediatrik kas-iskelet sistemindeki yumu\u015fak doku kitlelerinin de\u011ferlendirilmesindeki do\u011frulu\u011fu ve ek g\u00f6r\u00fcnt\u00fcleme ve giri\u015fimlerin s\u0131kl\u0131\u011f\u0131 nedir?<\/p>\n<p><strong>Tasar\u0131m<\/strong>:Retrospektif \u00e7al\u0131\u015fma (2007\u2019den 2011\u2019e kadar)<\/p>\n<p><strong>Merkez:<\/strong> Tek merkez; Lurie Children\u2019s Hospital of Chicago\/Northwestern University<\/p>\n<p><strong>Kat\u0131l\u0131mc\u0131lar:<\/strong> 456 yumu\u015fak doku, vask\u00fcler olmayan ultrasonografik incelemeler and 505 kitle (baz\u0131 hastalar birden fazla kitleye sahip)<\/p>\n<p><strong>M\u00fcdahale:<\/strong> Mevcut oldu\u011funda patolojik tan\u0131 ile kar\u015f\u0131la\u015ft\u0131r\u0131lan ultrasonografik de\u011ferlendirme. Kitlelerin, malignitesiz 2 y\u0131ll\u0131k takipten sonra &#8220;\u0130yi huylu&#8221; oldu\u011fu varsay\u0131ld\u0131. Hastan\u0131n 2 y\u0131ldan az klinik takibi varsa ve patolojik analizi yoksa da &#8220;Belirsiz&#8221; olarak kabul edildi.<\/p>\n<p><strong>\u00c7\u0131kt\u0131:<\/strong> Radyolojik izlenim: kitle yok, iyi huylu, muhtemelen iyi huylu, belirsiz, k\u00f6t\u00fc huylu; ek g\u00f6r\u00fcnt\u00fcleme s\u0131kl\u0131\u011f\u0131 ve radyolojik izlenime dayal\u0131 m\u00fcdahale oran\u0131<\/p>\n<p><strong>Ana Sonu\u00e7lar: <\/strong>Vakalar\u0131n %12,3&#8217;\u00fcnde kitle g\u00f6r\u00fclmedi. Vakalar\u0131n %41,7&#8217;si &#8220;\u0130yi Huylu&#8221;, %21,5&#8217;i &#8220;Muhtemelen \u0130yi Huylu&#8221;, %24,1&#8217;i &#8220;Belirsiz&#8221; ve %0,4&#8217;\u00fc &#8220;K\u00f6t\u00fc huylu&#8221; olarak kaydedildi. M\u00fcdahale oranlar\u0131 %7,1 (&#8220;Kitle Yok&#8221;) ile %100 (&#8220;K\u00f6t\u00fc huylu&#8221;) aras\u0131nda de\u011fi\u015fiklik g\u00f6sterdi. En s\u0131k MR g\u00f6r\u00fcnt\u00fcleme olmak \u00fczere toplam %9,4 vakada ek g\u00f6r\u00fcnt\u00fcleme elde edildi.<\/p>\n<p><strong>Yorum:<\/strong> Ara\u015ft\u0131rmac\u0131lar, ABD&#8217;de bulunan pediatrik yumu\u015fak doku kitlelerinin \u00e7o\u011funun iyi huylu oldu\u011funu ve nispeten az bir k\u0131sm\u0131na ek g\u00f6r\u00fcnt\u00fcleme yap\u0131ld\u0131\u011f\u0131n\u0131 ortaya koydu. Bununla birlikte, daha ciddi kitlelerin ultrasonografi ile tespit edilememesi olas\u0131 oldu\u011fu i\u00e7in MRG tekni\u011fi ba\u015flang\u0131\u00e7 y\u00f6ntemi olarak tercih edilebilir. &#8220;Muhtemelen \u0130yi Huylu&#8221; ve &#8220;Belirsiz&#8221; kategorilerinin m\u00fcdahale oranlar\u0131 benzerdi (s\u0131ras\u0131yla %32.7 ve %34.5), ancak &#8220;Muhtemelen \u0130yi Huylu&#8221; kitlelerin hi\u00e7birinde malignite saptanmad\u0131. Bu durum &#8220;Muhtemelen \u0130yi Huylu&#8221; kitleler i\u00e7in cerrahi m\u00fcdahaleden ziyade klinik ve g\u00f6r\u00fcnt\u00fcleme s\u00fcrveyans\u0131n\u0131n daha tercih edilebilir oldu\u011funu g\u00f6stermektedir.<\/p>\n<p>&nbsp;<\/p>\n<h3><strong><span style=\"color: #800080;\">N\u00d6RORADYOLOJ\u0130<\/span><\/strong><\/h3>\n<p>&nbsp;<\/p>\n<h5><span style=\"color: #3366ff;\"><strong>Rutin MR g\u00f6r\u00fcnt\u00fclemede pediatrik posterior fossa t\u00fcm\u00f6rlerini ay\u0131rt etmek i\u00e7in otomatik makine \u00f6\u011frenimi.<\/strong><\/span><\/h5>\n<p>Zhou H, Hu R, Tang O et al. Automatic machine learning to differentiate pediatric posterior fossa tumors on routine MR imaging.<\/p>\n<p><em>AJNR<\/em> 2020; 41: 1279\u201385.<\/p>\n<p><a href=\"http:\/\/dx.doi.org\/10.3174\/ajnr.A6621\">http:\/\/dx.doi.org\/10.3174\/ajnr.A6621<\/a><\/p>\n<p><strong>Soru: <\/strong>Otomatik makine \u00f6\u011frenimi modeli, pediatrik posterior fossa t\u00fcm\u00f6rlerini ay\u0131rt etme a\u00e7\u0131s\u0131ndan insan taraf\u0131ndan ol\u0131u\u015fturulmu\u015f bir model veya uzman n\u00f6roradyologlarla nas\u0131l kar\u015f\u0131la\u015ft\u0131r\u0131l\u0131r?<\/p>\n<p><strong>Tasar\u0131m:<\/strong> Retrospektif \u00e7al\u0131\u015fma<\/p>\n<p><strong>Merkez:<\/strong> Tek enstit\u00fc<\/p>\n<p><strong>Kat\u0131l\u0131mc\u0131lar:<\/strong> Pediatrik posterior fossa t\u00fcm\u00f6rl\u00fc 288 hasta<\/p>\n<p><strong>M\u00fcdahale:<\/strong> Bu \u00e7al\u0131\u015fmada \u00fc\u00e7 farkl\u0131 m\u00fcdahale y\u00f6ntemi kullan\u0131lm\u0131\u015ft\u0131r: 1)\u0130nsan m\u00fcdahalesi olmadan en uygun makine \u00f6\u011frenim d\u00fczenini se\u00e7en a\u00e7\u0131k kaynakl\u0131 bir makine \u00f6\u011frenimi bi\u00e7imi olan A\u011fa\u00e7 Tabanl\u0131 Ard\u0131\u015f\u0131k D\u00fczen Optimizasyon Arac\u0131 (TPOT) arac\u0131l\u0131\u011f\u0131yla otomatik makine \u00f6\u011frenimi, 2)\u0130nsan makine \u00f6\u011frenim uzman\u0131 taraf\u0131ndan standart manuel optimizasyonla olu\u015fturulan modeller (Chi-Square puan\u0131 \/ Genelle\u015ftirilmi\u015f Do\u011frusal Model), 3)kalitatif uzman MR g\u00f6r\u00fcnt\u00fcleme incelemesi (2 uzman N\u00f6roradyolog)<\/p>\n<p><strong>\u00c7\u0131kt\u0131:<\/strong> \u00dc\u00e7 yollu s\u0131n\u0131fland\u0131rmada (medulloblastom, ependimom, pilositik astrositom)ve ikili s\u0131n\u0131fland\u0131rmada (medulloblastoma ve medulloblastoma olmayan, ependimom ve ependimom olmayan, pilositik astrositom ve pilostik astrositom olmayan) makine \u00f6\u011frenim uzman\u0131 ve kalitatif uzman MR okuyucular\u0131 taraf\u0131ndan se\u00e7ilen TPOT\u2019un do\u011frulu\u011fu<\/p>\n<p><strong>Ana Sonu\u00e7lar:<\/strong> 3 yollu s\u0131n\u0131fland\u0131rma i\u00e7in TPOT, 0,83 do\u011frulukla 0,91 AUC (e\u011frinin alt\u0131nda kalan alan) elde ederken, Ki-Kare skoru \/ Genelle\u015ftirilmi\u015f Do\u011frusal Model\u2019in AUC skoru 0.92\u2019ydi (0.74 do\u011fruluk pay\u0131yla). TPOT, ortalama kalitatif uzman taraf\u0131ndan yap\u0131lan MRG incelemesinden \u00f6nemli \u00f6l\u00e7\u00fcde daha y\u00fcksek bir do\u011fruluk elde etti (0.83&#8217;e kar\u015f\u0131 0.54, P &lt;0.001).\u00a0 \u0130ki makine \u00f6\u011frenimi modeli aras\u0131nda da istatistiksel \u00f6nemli bi fark g\u00f6zlenmedi (P = 0.16). \u0130kili s\u0131n\u0131fland\u0131rmada AUC skorlar\u0131 medulloblastom ve medulloblastom olmayan i\u00e7in 0.85 do\u011fruluk pay\u0131yla 0.94, ependimom ve ependimom olmayan i\u00e7in 0.8 do\u011fruluk pay\u0131yla 0.84, pilositik astrositom ve pilostik astrositom olmayan i\u00e7in 0.88 do\u011fruluk pay\u0131yla 0.94.<\/p>\n<p><strong>Yorum:<\/strong> Otomatik makine \u00f6\u011frenimi modeli, uzman radyologlardan daha iyi; insan makine \u00f6\u011frenimi uzman\u0131 taraf\u0131ndan yap\u0131lan manuel optimizasyona dayal\u0131 bir makine \u00f6\u011frenimi modeline benzer \u015fekilde performans g\u00f6sterebilir. Bu durumun hi\u00e7 de \u015fa\u015f\u0131rt\u0131c\u0131 olmamas\u0131n\u0131n sebebi makine \u00f6\u011frenim modelinin model tan\u0131ma konusunda olduk\u00e7a iyi olmas\u0131d\u0131r. Bu sonu\u00e7lara ra\u011fmen, makine \u00f6\u011frenimi, histopatolojik tan\u0131 i\u00e7in referans standard\u0131 ihtiyac\u0131n\u0131 ortadan kald\u0131rmaz.<\/p>\n<p>&nbsp;<\/p>\n<h3><span style=\"color: #800080;\"><strong>KAL\u0130TE &amp; G\u00dcVENL\u0130K<\/strong><\/span><\/h3>\n<p>&nbsp;<\/p>\n<h5><span style=\"color: #3366ff;\"><strong>Pediatrik acil servislerde geli\u015fmi\u015f g\u00f6r\u00fcnt\u00fcleme kullan\u0131m\u0131ndaki ak\u0131mlar, 2009-2018<\/strong><\/span><\/h5>\n<p>Marin JR, Rodean J, Hall M, et al. Trends in Use of Advanced Imaging in Pediatric Emergency Departments, 2009-2018<em>.\u00a0<\/em><\/p>\n<p><em>JAMA Pediatr.<\/em>\u00a0Published online August 03, 2020.<\/p>\n<p><a href=\"https:\/\/doi.org\/10.1001\/jamapediatrics.2020.2209\">https:\/\/doi.org\/10.1001\/jamapediatrics.2020.2209<\/a>.<\/p>\n<p><strong>Soru:<\/strong>\u00a0 ABD&#8217;deki pediatrik acil servislerinde son 10 y\u0131lda geli\u015fmi\u015f g\u00f6r\u00fcnt\u00fcleme kullan\u0131m\u0131 nas\u0131l de\u011fi\u015fti?<\/p>\n<p><strong>Tasar\u0131m <\/strong>2009\u2019dan 2018\u2019e kesitsel \u00e7al\u0131\u015fma<\/p>\n<p><strong>Merkez: <\/strong>ABD&#8217;deki 52 adet \u00fc\u00e7\u00fcnc\u00fc basamak \u00e7ocuk hastanesinden al\u0131nan verileri i\u00e7eren veritaban\u0131n\u0131 (Pediatrik Sa\u011fl\u0131k Bilgi Sistemi) kullanan \u00e7ok merkezli \u00e7al\u0131\u015fma<\/p>\n<p><strong>Kat\u0131l\u0131mc\u0131lar: <\/strong>32 acil servis, 26 milyondan fazla pediatrik acil servis ziyareti<\/p>\n<p><strong>\u00c7\u0131kt\u0131:<\/strong> 10 y\u0131l boyunca BT, ultrasonografi ve MR g\u00f6r\u00fcnt\u00fcleme kullan\u0131m\u0131ndaki de\u011fi\u015fim. \u0130kincil sonu\u00e7lar, acil serviste yat\u0131\u015f s\u00fcresi, hastaneye yat\u0131\u015flar ve 3 g\u00fcnl\u00fck acil servise tekrar ziyaret oranlar\u0131n\u0131 i\u00e7eriyordu.<\/p>\n<p><strong>Ana Sonu\u00e7lar: <\/strong>9,868,406\u2019s\u0131 \u00e7ocuk olmak \u00fczere toplamda 26,082,062 acil servis ziyareti ger\u00e7ekle\u015ftirildi. 1,919,283 adet ileri g\u00f6r\u00fcnt\u00fclenme (BT, ultrasonografi ve MRG) ger\u00e7ekle\u015ftirildi. 2009\u2019daki ziyaretlerin %6.4\u2019\u00fc ileri g\u00f6r\u00fcnt\u00fclemeyken 2018 y\u0131l\u0131na gelindi\u011finde bu oran %8.7\u2019ye \u00e7\u0131kt\u0131. Bilgisayarl\u0131 tomografinin kullan\u0131m oran\u0131 %1 d\u00fc\u015ferken (3.9\u2019dan 2.9\u2019a) ultrasonografi %3.3 oran\u0131nda (2.5\u2019den 5.8\u2019e), MRG de %0.3 oran\u0131nda (0.3\u2019den 0.6\u2019ya) artt\u0131. P &lt;0.001 ile t\u00fcm de\u011fi\u015fiklikler istatistiksel olarak \u00f6nemli g\u00f6r\u00fcld\u00fc. Genel olarak, hastaneye yat\u0131\u015flar ve 3 g\u00fcnl\u00fck acil servise tekrar ziyaret oranlar\u0131 azald\u0131.<\/p>\n<p><strong>Yorum: <\/strong>Son 10 y\u0131lda, pediatrik acil servis ziyaretlerindeki ileri g\u00f6r\u00fcnt\u00fclemenin kullan\u0131m\u0131nda genel bir art\u0131\u015f olmu\u015ftur. US ve MRG gibi iyonize radyasyon i\u00e7ermeyen modalitelerin kullan\u0131m\u0131 artarken BT kullan\u0131m\u0131 azalm\u0131\u015ft\u0131r. Bunun nedeni, \u201cImage Gently and Choosing Wisely\u201d gibi kampanyalar\u0131n yan\u0131 s\u0131ra, abdominal patolojinin te\u015fhisinde ultrason kullan\u0131m\u0131n\u0131n artmas\u0131 olabilir. Daha h\u0131zl\u0131, daha k\u0131sa MRG protokolleri art\u0131k \u015fantlar\u0131 sedasyon olmadan de\u011ferlendirmek i\u00e7in kullan\u0131labilir. Ultrason kullan\u0131m\u0131ndaki genel art\u0131\u015f\u0131n, BT\u2019deki d\u00fc\u015f\u00fc\u015fle e\u015fle\u015fmemesi ultrasonun \u015fu anda a\u015f\u0131r\u0131 kullan\u0131lmas\u0131na ve daha geni\u015f bir endikasyon yelpazesine uygulanmas\u0131 olas\u0131l\u0131\u011f\u0131n\u0131 art\u0131r\u0131yor. Bu \u00e7al\u0131\u015fman\u0131n k\u0131s\u0131tl\u0131l\u0131klar\u0131, endikasyonlar\u0131n de\u011ferlendirilmemesi ve yaln\u0131zca \u00fc\u00e7\u00fcnc\u00fc basamak \u00e7ocuk hastanelerinin dahil edilmesidir, bu nedenle bu sonu\u00e7lar di\u011fer ortamlara genellenemez. \u00dc\u00e7\u00fcnc\u00fc basamak olmayan baz\u0131 hastaneler, BT yerine MRG veya ultrasonu se\u00e7ecek teknolojiye ve sonograf e\u011fitimine \/ personeline sahip olmayabilir.<\/p>\n","protected":false},"excerpt":{"rendered":"ABDOM\u0130NAL G\u00d6RNT\u00dcLEME &nbsp; Apandisit te\u015fhisinde ultrasonun tan\u0131sal do\u011frulu\u011fundaki de\u011fi\u015fikliklerin de\u011ferlendirmesi: Pratik yapmak m\u00fckemmelle\u015ftirir mi? Austin-Page [&hellip;]","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-8226","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized-tr"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.1 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>What\u2019s new in Pediatric Imaging (Turkish) \u2013 September 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-september-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 September 2020 - ACORE\" \/>\n<meta property=\"og:description\" content=\"ABDOM\u0130NAL G\u00d6RNT\u00dcLEME &nbsp; Apandisit te\u015fhisinde ultrasonun tan\u0131sal do\u011frulu\u011fundaki de\u011fi\u015fikliklerin de\u011ferlendirmesi: Pratik yapmak m\u00fckemmelle\u015ftirir mi? 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