Publication: Çocuk Yoğun Bakım Hastalarında Ultrasonografi ile Yapılan_x000D_
Optik Sinir Kılıf Çapı Ölçümlerinin Diğer Kraniyal Görüntüleme_x000D_
Yöntemleriyle (Kraniyal Bilgisayarlı Tomografi ve Manyetik_x000D_
Rezonans Görüntüleme) Karşılaştırılması
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Giriş: Optik sinir kılıfı çapı (OSKÇ) kafa içi basınç artışı (KİBA) tanısınınkoyulması için ölçülür. Bilgisayarlı Tomografi (BT) ve ManyetikRezonans görüntüleme (MRI) KİBA tespiti için sık kullanılır. Sonzamanlarda ultrasonografik (US) yaklaşımla yapılan OSKÇ ölçümleriyatak başında kolayca yapılabilmesi ve sık tekrarlanabilir olmasınedeniyle seçenek bir yöntem olarak öne çıkmaktadır. ÇalışmamızdaUS ile yatak başında yapılan OSKÇ ölçümlerinin BT ve MRI ile yapılanölçümlerle uyumu araştırıldı.Yöntemler: Araştırmamız tek merkezli, ileriye yönelik bir çalışmadır.Herhangi bir sebeple beyin BT/MRI’sı çekilmiş olup US uygulanabilentüm 1 ay-18 yaş entübe hastalar, aile onamı alınarak çalışmayadahil edildi. Tek bir nöroradyolog tarafından ölçülen BT/MRI OSKÇdeğerleri ile tek bir araştırmacı tarafından saptanan US değerlerikarşılaştırıldı.Bulgular: Çalışmamızda toplam 94 ölçüm yapıldı. US ile sağ gözdeortalama OSKÇ 4,56±0,66 cm, sol gözde ise 4,52±0,63 cm idi. BT/MRI ölçümleri ise sağda 4,65±0,72 cm, solda 4,46±0,67 cm idi.Sağ ve sol taraflı US ve BT/MRI ortalama ölçümleri arasında anlamlıfark yoktu (p=0,4). Sağ OSKÇ için BT ve US ölçümleri arasındakikorelasyon kat sayısı r=0,448 (p=0,002), sol OSKÇ için ise r=0,448(p=0,001) olup, BT ve US ölçümlerinde korelasyon her iki göz OSKÇiçin lineer artış göstermekte ve aralarında orta derecede korelasyonbulunmaktaydı. Santral görüntüleme ile US arasında geçen sürenin5 saatin altında olduğu 8 olguda BT/MRI ve US ile yapılan OSKÇölçümleri arasındaki korelasyonun arttığı (sağ r=0,774, p=0,024: solr=0,811, p=0,014) görüldü.Sonuç: Çalışmamızda entübe yoğun bakım hastalarında US ve BT/MRI OSKÇ ölçümleri uyumlu bulundu. Görüntülemeler arasındakizaman 5 saatin altında olduğunda uyum daha da artmakta idi. Yoğunbakım ünitelerinde entübe hastalarda KİBA’nın klinik takibinde USile yapılan seri OSKÇ ölçümlerinin kullanılması; non-invazif, güvenilirmaliyet etkin olabilecek bir yöntemdir
Introduction: Optic nerve sheath diameter (ONSD) measurements_x000D_ aid in diagnosis of increased intracranial pressure (ICP). Computed_x000D_ tomography (CT) and magnetic resonance imaging (MRI) are_x000D_ commonly used modalities for detecting ICP. Lately, ONSD_x000D_ measurements via ultrasound (US) are getting popular as an_x000D_ alternative method due to the ease of performance at the bedside_x000D_ and repeatability. Our study objective was to investigate whether US_x000D_ measurements correlated with CT/MRI counterparts._x000D_ Methods: This was a single-center, prospective study. All intubated_x000D_ patients aged 1 month-18 years with a cranial CT/MRI for any_x000D_ indications, who could be scanned ultrasonographically, were_x000D_ included after parental consent. Optic nerve US was performed_x000D_ by a single investigator. CT/MRI ONSDs were measured by a_x000D_ neuro-radiologist. Data obtained from US and CT/MRI scans were_x000D_ compared._x000D_ Results: A total of 94 different measurements were obtained. The_x000D_ mean ONSD in US and CT was 4.56±0.66 cm and 4.65±0.72cm on_x000D_ the right side, whereas the mean left ONSD was 4.52±0.63 cm and_x000D_ 4.46±0.67 cm, respectively (p=0.4). Correlation coefficient for right_x000D_ ONSD was r=0.448 (p=0.002) while it was r=0.448 (p=0.001) for_x000D_ left ONSD. Both CT and US measurements showed a linear increase,_x000D_ and the correlation between them was moderate._x000D_ A subgroup of 8 patients who had less than 5 hours between their_x000D_ central imaging and US scan showed strong correlation between_x000D_ measurements for both right and left ONSD [r=0.774, (p=0.024)_x000D_ and r=0.811 (p=0.014), respectively]._x000D_ Conclusion: There was a correlation between US and CT/MRI ONSD_x000D_ measurements in our study. The correlation was stronger when the_x000D_ time interval was less than 5 hours between measurements. Our_x000D_ findings suggest that US may be a useful, reliable and cost-effective_x000D_ method for assessment and clinical follow-up of increased ICP in_x000D_ intubated pediatric intensive care unit patients.
Introduction: Optic nerve sheath diameter (ONSD) measurements_x000D_ aid in diagnosis of increased intracranial pressure (ICP). Computed_x000D_ tomography (CT) and magnetic resonance imaging (MRI) are_x000D_ commonly used modalities for detecting ICP. Lately, ONSD_x000D_ measurements via ultrasound (US) are getting popular as an_x000D_ alternative method due to the ease of performance at the bedside_x000D_ and repeatability. Our study objective was to investigate whether US_x000D_ measurements correlated with CT/MRI counterparts._x000D_ Methods: This was a single-center, prospective study. All intubated_x000D_ patients aged 1 month-18 years with a cranial CT/MRI for any_x000D_ indications, who could be scanned ultrasonographically, were_x000D_ included after parental consent. Optic nerve US was performed_x000D_ by a single investigator. CT/MRI ONSDs were measured by a_x000D_ neuro-radiologist. Data obtained from US and CT/MRI scans were_x000D_ compared._x000D_ Results: A total of 94 different measurements were obtained. The_x000D_ mean ONSD in US and CT was 4.56±0.66 cm and 4.65±0.72cm on_x000D_ the right side, whereas the mean left ONSD was 4.52±0.63 cm and_x000D_ 4.46±0.67 cm, respectively (p=0.4). Correlation coefficient for right_x000D_ ONSD was r=0.448 (p=0.002) while it was r=0.448 (p=0.001) for_x000D_ left ONSD. Both CT and US measurements showed a linear increase,_x000D_ and the correlation between them was moderate._x000D_ A subgroup of 8 patients who had less than 5 hours between their_x000D_ central imaging and US scan showed strong correlation between_x000D_ measurements for both right and left ONSD [r=0.774, (p=0.024)_x000D_ and r=0.811 (p=0.014), respectively]._x000D_ Conclusion: There was a correlation between US and CT/MRI ONSD_x000D_ measurements in our study. The correlation was stronger when the_x000D_ time interval was less than 5 hours between measurements. Our_x000D_ findings suggest that US may be a useful, reliable and cost-effective_x000D_ method for assessment and clinical follow-up of increased ICP in_x000D_ intubated pediatric intensive care unit patients.