Congenital seminal vesicle cyst accompanying with ipsilateral renal agenesis in an adolescent patient: A pediatric radiologist approach to Zinner’s syndrome

A fifteen-year-old boy who had complaints of left sided pelvic pain with known ipsilateral left renal agenesia was referred to pediatric radiology department. Incidentally, his sonography examination revealed a dilated tubular structure located in the retro-vesicular region from cephalic to prostate. Contrast enhanced pelvic MRI showed a huge seminal vesicle cyst which is over 6 cm without a mass effect near the aspect border of the prostate and bladder. The patient was diagnosed with Zinner syndrome. The patient doesn’t have new complaint with no definite increase in the diameter of the cyst. In this case presentation we are discussing the Zinner syndrome’s imaging findings from a pediatric radiologist approach with a brief review of the literature

Prenatal diagnosis of torcular herophili thrombosis with unfavored outcome and review

Prenatally diagnosed thrombosis of the torcular herophili is a rare described entity. There are about 50 cases described in the literature till now. We here discuss the radiological findings of dural sinus thrombosis at the torcular herophili with extension into the superior sagittal sinus demonstrated on fetal magnetic resonance imaging (MRI) at the second trimester. After birth, the infancy was followed up to sixth months with serial MRI. During this period there was moderate reduction in the size of the thrombus. There was not any underlying cause for the thrombus both in the mother and the infancy. Unexpectedly, the cranial MRI revealed the signs of cerebral atrophy at the age of sixth month. Regarding the cerebral atrophy in a prenatally diagnosed torcular herophili thrombus, there was not a sample of this combination in the literature before. In this presentation we discuss the radiologic and clinical findings of prenatally diagnosed torcular herophili within the review of the literature

Epiploic Appendagitis as a Rare Cause of Acute Abdomen in the Pediatric Population: Report of Three Cases

WOS: 000426072300015PubMed: 29531496Epiploic appendagitis, caused by inflammation of small adipose tissue on the colon wall, is a rare cause of acute abdominal pain in the pediatric population. It is nearly impossible to establish a specific diagnosis merely on the basis of clinical findings; thus, radiological evaluation is always necessary. In this report, we present the cases of three children with abdominal pain who were diagnosed with epiploic appendagitis. All cases were successfully treated with conservative management

Acoustic Radiation Force Impulse Quantification in the Evaluation of Renal Parenchyma Elasticity in Pediatric Patients With Chronic Kidney Disease

WOS: 000406344700003PubMed: 28390141Objectives-To evaluate renal parenchymal elasticity with acoustic radiation force impulse imaging in pediatric patients with chronic kidney disease (CKD) and compare with healthy volunteers. Methods-Thirty-eight healthy volunteers and 30 pediatric CKD patients were enrolled in this prospective study. The shear wave velocity (SW) values of both kidneys in CKD patients and healthy volunteers were evaluated. Results-The mean SW in healthy volunteers was 2.2160.34 m/s, whereas the same value was 1.81 +/- 0.49, 1.72 +/- 0.63, 1.66 +/- 0.29, 1.48 +/- 0.37, and 1.23 +/- 0.27 for stages 1, 2, 3, 4, and 5 in CKD patients, respectively. The SW was significantly lower for each stage in the CKD patients compared with healthy volunteers. Acoustic radiation force impulse could not predict the different stages of CKD, with the exception of stage 5. The cut-off value for predicting CKD was 1.81 m/s; at this threshold, sensitivity was 76.5% and specificity was 92.1% (area under the curve = 0.870 [95% confidence interval: 0.750-0.990]; P < .001). Interobserver agreement expressed as intraclass coefficient correlation was 0.65 (95% confidence interval: 0.34 to 0.83; P < .001). Conclusions-Acoustic radiation force impulse may be a potentially useful tool in detecting CKD in pediatric patients

A Rare Cause of Carpal Tunnel Syndrome: Volar Lunate Dislocation

Scientific BACKGROUND: Carpal tunnel syndrome (CTS) is a common neuropathy caused by entrapment of the median nerve at the wrist. Although most cases are idiopathic, CTS may be rarely associated with space occupying lesions. Volar lunate dislocation is a rare cause of CTS and may be easily misdiagnosed especially in patients with multiple traumas or when inadequate radiographs are obtained. CASE: A 29-year-old right handed man was complaining of numbness in thumb, index and middle fingers of the right hand for two months. He was diagnosed with CTS by clinically and electrophysiologicaly on the right hand. Enlarged median nerve caused by compression of dislocated lunate bone was demonstrated by radiological findings. CONCLUSION: Possible structural lesions may exist in patients with atypical clinical features of CTS, and radiological imaging modalities would be needed for diagnosi

Acoustic Radiation Force Impulse Imaging in the Differential Diagnosis of an Ectopic Intrathyroidal Thymus

Ectopic intrathyroidal thymus is caused by a hesitate in the migration of thymus during embryogenesis and is a rare cause of a nodular intrathyroidal lesion. Nodular thyroid lesions raise the suspicion of malignancy in the pediatric age group. Although rare, ectopic intrathyroidal thymus is usually misdiagnosed as a thyroid nodule and in addition to ultrasonography, further imaging techniques including MRI is performed. Fine needle aspiration biopsy or surgical excision, are also included in the management in thyroid nodules, because of the possibility of a malignancy. Acoustic Radiation Force Impulse-Imaging (ARFI) is a new method determining the tissue elasticity using short duration acoustic pulces and exciting the tissue in the selected region of interest. Acoustic Radiation Force Impulse-Imaging had been used in the differentiation of malign and benign thyroid nodules with or without in combination with gray-scale ultrasonography findings. We here present a case of intrathyroidal ectopic thymus in a 4 year-old boy diagnosed with the use of Acoustic Radiation Force Impulse-Imaging in addition to gray scale and Doppler ultrasonography findings.</p

Quantitative assessment of muscle stiffness with acoustic radiation force impulse elastography after botulinum toxin A injection in children with cerebral palsy

WOS: 000418965300019PubMed: 28271231Our objective in this study was to assess the changes in medial gastrocnemius muscle (GCM) stiffness after botulinum toxin A (BTA) injection in children with cerebral palsy (CP) by using acoustic radiation force impulse (ARFI) elastography and to research the usability of this technique in clinical practice. Twenty-four spastic lower extremities of 12 children with CP were assessed. BTA injection treatment was applied to the medial GCM. Muscle stiffness was measured with the ARFI technique before the procedure and a month after the procedure. The patients were assessed with the modified Ashworth scale (MAS) in the physiotherapy department at about the same time. Shear wave velocity (SWV) values and MAS scores before and after the treatment were compared. Mean SWV values were measured as 3.20 +/- 0.14 m/s before BTA and as 2.45 +/- 0.21 m/s after BTA, and the difference between them was found to be statistically significant (p < 0.001). Mean MAS score (2.33 +/- 0.70) after BTA decreased significantly when compared to the score before BTA (2.96 +/- 0.62) (p = 0.001). SWV values positively correlated with MAS scores (rho = 0.578, p = 0.003). The interobserver agreement expressed as interclass correlation coefficient (ICC) was 0.65 (95% CI 0.33-0.84, p < 0.001). ARFI elastography for identifying structural changes that occur in the spastic muscle after BTA injection in children with CP can yield more valuable information with combined use of MAS