Measurement of normal spleen volume and dimensions in all child age groups by abdominal computed tomography.

OBJECTIVE: This study aimed to calculate the spleen size and volume, portal vein diameter, splenic vein diameter, and accessory spleen presence in children aged 0-18 years in the Turkish population by computed tomography, according to age and gender. MATERIALS AND METHODS: Abdominal computed tomography images of 406 children without systemic or organospecific disease were retrospectively analyzed in the study. Maximum interpolar length in axial and coronal sections in addition to maximum width at hilus level in axial sections of the spleen were measured in abdominal computed tomography. Luminal diameter measurements were obtained from axial sections at the level of the liver hilum of the portal vein and the hilus of the spleen of the splenic vein. RESULTS: As age increases, the axial longest dimension (ALD), axial longest thickness (ALT) and coronal longest dimension (CLD) dimensions also increase, and this increase is statistically significant (p<0.001). The lowest splenic volume was measured in the 0-2 age group as 25.3 cm3, and the highest splenic volume was 506.2 cm3 in the 17-18 age group. Splenic vein diameter is between 1.9 mm and 11.0 mm, and the mean splenic vein diameter increases with increasing age. Portal vein diameter is between 4.1 mm and 14.9 mm, and the average portal vein diameter increases with age. The accessory spleen was seen in 22 (5.4%) children. Accessory spleen size ranged from 5 mm to 17 mm. There was a strong positive correlation between spleen volume and splenic vein diameter (r=0.696 p<0.001). Similarly, there was a strong positive correlation between spleen volume and portal vein diameter (r=0.704 p<0.001). CONCLUSIONS: It may be helpful to know the normal spleen volume in healthy children according to age groups in making the correct diagnosis of splenomegaly. We assume that it will play an important role in the accurate diagnosis of portal hypertension to know the upper and lower limits of the portal vein and splenic vein diameters.

Can evaluating adrenal glands in computed tomography contribute to predicting the prognosis of hospitalized COVID-19 patients?

OBJECTIVE: The novel coronavirus disease 2019 (COVID-19) may affect the adrenal glands. Therefore, it is important to evaluate the morphologic appearance of the adrenal glands by thorax computed tomography (CT). On CT scans, stranding in peripheral fatty tissue with enlarged adrenal glands may indicate signs of adrenal infarction (SAI). The present study aimed to evaluate the incidence of SAI and determine whether this finding may contribute to predictions of the prognosis of COVID-19. PATIENTS AND METHODS: A total of 343 patients who had been hospitalized at Malatya Training and Research Hospital between September 1 and 30, 2020, with a diagnosis of COVID-19 were enrolled in this study. All patients underwent thorax CT scans that included their adrenal glands. RESULTS: Of the enrolled patients, 16.0% had SAI. Moreover, 41.8% of patients with SAI and 15.3% of patients without SAI were treated in the Intensive Care Unit (ICU). Patients with SAI had a significantly higher rate of ICU admission (p < 0.001). Mortality rates were also significantly higher among patients with SAI than those without p < 0.001). CONCLUSIONS: In this study, it was found that COVID-19 patients with SAI may have a poorer prognosis. More comprehensive studies are needed on this subject, but the present study may provide helpful preliminary information in terms of prognosis.

The evaluation of the trachea as a new parameter in determining the prognosis of COVID-19: first pilot study.

OBJECTIVE: Coronavirus disease-2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) follows a biphasic disease model consisting of an early viral response phase and an inflammation phase. SARS-CoV-2 has a high affinity for the upper respiratory tract and conjunctiva; hence, it can infect the upper respiratory tract and facilitate airway inflammation. COVID-19 also affects the tracheal epithelial cells. We hypothesized that the size of the trachea increases depending on the severity of the disease, and this increase is an indicator of poor prognosis. There are no studies on this subject in literature, to the best of our knowledge. For this purpose, in this study, the tracheas of 326 patients who reported to the radiology clinic were examined by evaluating the thoracic computed tomography (CT) images. PATIENTS AND METHODS: The patients who were admitted to the Malatya Training and Research Hospital between September and December 2020, had a positive SARS-CoV-2 nasopharyngeal reverse transcription-polymerase chain reaction result, and had undergone thoracic CT, were included in the study. The thoracic CT scans without respiratory artifacts were evaluated, and anteroposterior (AP) and transverse diameters of the trachea were measured at the thyroid and bifurcation levels. RESULTS: We believe that a tracheal AP diameter of >20 mm at the thyroid level and a tracheal AP diameter of 18 mm at the thyroid bifurcation level (according to Group 3 and Group 4) may be indicators of poor prognosis. In terms of survival, a tracheal AP diameter of >18 mm at the bifurcation level can be considered as a poor prognostic factor. CONCLUSIONS: The tracheal diameter may increase in proportion to the severity of inflammation, indicating or accompanying a poor prognosis. Patients with extensive involvement should be monitored closely for the development of tracheal stenosis.