Vascular imaging findings with high-pitch low-dose dual-source CT in atypical Kawasaki disease

PURPOSE:Determining the presence of aneurysms, thrombosis, and stenosis is very important for the diagnosis of atypical Kawasaki disease (AKD) and in the follow-up of AKD patients with aneurysms. We aimed to demonstrate high-pitch low-dose dual-source computed tomography (CT) angiography findings in pediatric patients with AKD.METHODS:Over a 5-year period, high-pitch low-dose CT angiography was performed to determine vascular aneurysms or occlusions in 17 patients who had suspected AKD. The patients ranged from 2 months of age to 11.3 years, with a mean age of 3 years. The American Heart Association’s criteria were used to diagnose AKD.RESULTS:We did not detect any vascular problems in 6 of the patients, and they were not included in our study. Arterial aneurysms were present in 11 patients (aged 2 months to 11.3 years; mean age, 4.2 years; 7 males). In one patient, there was also a thrombus at an arterial aneurysm. Coronary artery aneurysms were detected in 7 patients and systemic artery aneurysms were detected in 7 patients. Three patients had both systemic and coronary aneurysms.CONCLUSION:Our results suggest that high-pitch low-dose dual-source CT can detect all types of aneurysms, stenosis and occlusions of vessels in patients with AKD who were not previously diagnosed. This useful, easy, robust and fast technique may be preferred to diagnose AKD

The value of dual-energy computed tomography in the evaluation of myocarditis

PURPOSEThe inflammation of the heart muscle is referred to as acute myocarditis. Cardiac magnetic resonance imaging (CMR) has become the primary method for a non-invasive assessment of myocardial inflammation. However, there are several drawbacks of CMR. During the last decade, dual energy computed tomography (DECT) has been used in cardiac imaging. The current study aims to assess the efficacy and feasibility of DECT in acute myocarditis and compare the results to CMR.METHODSThis prospective study included patients who had myocarditis but no coronary artery pathology. Two observers evaluated the patients for acute myocarditis using DECT and CMR. CMR was performed on 22 patients within 24 hours of DECT, which was administered within 12 hours following the onset of chest pain. Inter-observer agreement was tested with Cohen’s Kappa coefficient, and Spearman’s correlation was used to examine the possible correlations. A P value of <0.050 was accepted as statistically significant.RESULTSThe DECT and CMR agreement was significant for transmural diagnoses, excellent for subepicardial and intramyocardial diagnoses, and perfect for nodular and band-like patterns.CONCLUSIONThe findings of this study showed that the dark areas on the color-coded iodine map created with DECT were strongly correlated with CMR in acute cases of myocarditis. In addition, DECT is a robust imaging method that can also be used in the diagnosis of acute myocarditis. Furthermore, it provides information about coronary arteries faster and more reliably than magnetic resonance imaging without any limitations

Digoxin toxicity in childhood: Report of 12 cases

Digoksin terapötik penceresinin dar olması nedeniyle toksik bir ilaçtır. Bu nedenle dijitalize hastalarda %35’lere varan oranda intoksikasyonun bildirilmiş olması şaşırtıcı de¤ildir. Dijital intoksikasyonunun iki major nedeni vardır; tedavi amacıyla digoksin alımı ve kaza ile yüksek doz digoksin alımı. Bu çalışmada 1998-2007 yılları arasında 12 digoksin intoksikasyonlu hasta retrospektif olarak incelendi. Hastaların intoksikasyon nedenleri, klinik bulguları, EKG özellikleri, kan digoksin düzeyleri sunuldu. Digoksin intoksikasyonunun önemi, tedavide yapılması gerekenler vurgulandı.Digoxin is a toxic drug with a narrow therapeutic window. In view of this it is perhaps not surprising that toxicity is a common occurence, being reported in up to 35% of digitalized patients. The major causes of digitalis toxicity in infants and children are therapeutic administration and acute accidental overdose. In this retrospective study, we evaluate 11 patients with digoxin toxicity during 1998-2007. The cause of patient's intoxication, clinical observations, ECG features and blood digoxin levels are presented. The significance of digoxin intoxication and its treatment options are discussed

Infra-renal abdominal aorta hypoplasia in a case of Down syndrome depicted by multidetector computed tomography angiography

We report the case of a 3-day-old newborn with Down syndrome suffering from congenital infra-renal aortic hypoplasia. To our knowledge, this is the first report of a Down syndrome case with infra-renal abdominal aorta hypoplasia depicted by multidetector computed tomography angiography. In cases with no palpable pulsations in the lower extremities, multidetector computed tomography angiography is a fast and reliable diagnostic tool for the evaluation of distal aortic lesions. J Cardiovasc Med 10:276-278 (C) 2009 Italian Federation of Cardiology

EFFECT OF ADENOTONSILLECTOMY ON THE RIGHT VENTRICULAR DIASTOLIC FUNCTIONS IN CHILDREN WITH ADENOTONSILLAR HYPERTROPHY

WOS: 000435637700015The present study aimed to investigate the right ventricular function in children with obstructive adenotonsillar hypertrophy. For this purpose, right ventricular diastolic functions were evaluated via echocardiography before adenotonsillectomy and after a minimum of 6 months following surgery. Children with adenotonsillar hypertrophy who were admitted to our clinic with the complaints of snoring, mouth breathing, and/or witnessed apnea were included. Pre-operatively, a complete blood cell count, routine biochemical blood tests, chest radiography, electrocardiography, and tissue Doppler echocardiography were performed. Electrocardiography and tissue Doppler echocardiography were repeated on the follow-up visits of the patients a er a minimum of 6 months following adenotonsillectomy. Evaluation of the patients in the post-operative 6th month revealed no snoring or apnea in any of the patients. Although significant changes were detected in certain echocardiographic parameters a er the surgery, right ventricular morphological abnormalities were not detected. Also, echocardiographic measurements of le ventricular dimensions were within the normal limits. Nevertheless, the ratio of peak early to late tissue motion velocity of the tricuspid valve as determined by tissue Doppler imaging was higher in the post-operative period than in the pre-operative period. This might be attributed to the relative improvement in diastolic functions