scholarly journals The Frequency of Emergence Delirium in Children Undergoing Outpatient Anaesthesia for Magnetic Resonance Imaging

Author(s):  
Derya Karasu ◽  
Umran Karaca ◽  
Seyda Efsun Ozgunay ◽  
Canan Yilmaz ◽  
Ferit Yetik ◽  
...  

Background: The aim of this study was to investigate the effect on the occurrence of emergence delirium of propofol and ketofol with intranasal dexmedetomidine and midazolam applied as premedication to paediatric patients during magnetic resonance imaging (MRI). Methods: The study included children aged 2-10 years who received sedation for MRI, separated into four groups. Group MP received intranasal midazolam (0.2 mg/kg) for premedication and IV propofol (1 mg/kg) as the anaesthetic agent. Group MK received intranasal midazolam (0.2 mg/kg) for premedication and IV ketofol (1 mg/kg) as the anaesthetic agent. Group DP received intranasal dexmedetomidine (1 mcg/kg) for premedication and IV propofol (1 mg/kg) as the anaesthetic agent. Group DK received intranasal dexmedetomidine (1 mcg/kg) for premedication and IV ketofol (1 mg/kg) as the anaesthetic agent. The Paediatric Anaesthesia Emergence Delirium (PAED) scale was used to evaluate delirium. A PAED score ≥ 10 was accepted as delirium. Results: The need for additional anaesthetic was highest in Group DP at 94.3% and lowest in Group DK at 14.3%. The mean Aldrete and PAED scores were lower and the length of stay in the recovery room was shorter in Group DP than in the other groups. Delirium only developed in two patients in Group MP (5.7%) at 5 mins after anaesthesia. Conclusion: In our study, delirium was seen at a very low rate only in the Group MP and it is difficult to say the best combination in terms of delirium frequency with this result.

Author(s):  
Rihab A. Yousif Ahmed ◽  
Awadia G. Suliman ◽  
Abdulmalek Y. Abdullah ◽  
Alrayah A. Mohammed ◽  
Amna R. Abdulghani ◽  
...  

Background: Much congenital and intracranial pathology may affect optic nerve (ON) and caused increased or decreased in size, so the measurement is crucial and aiding in diagnosed of some neurogenic and endocrine disorders. The aim of this study was to measure the normal ON length and diameter by magnetic resonance imaging among pediatric at Khartoum state Sudan.Methods: This was descriptive, cross section study,  done in 100 Sudanese pediatrics with age from 1 month to 15 years came to Magnetic resonance imaging (MRI) department for MRI brain at three hospitals in Khartoum state  (Al-Amal national hospital, Al-Zaitona hospital and Modern Medical Center) during the period from December 2019 to March 2020, all of patients had no pathological or medical condition that may affect the orbits and optic nerve (OON), any child with and medical condition or pathology related to orbits excluded from study sampling. The data were collected by data collection sheet designed especially for this study then analyzed.Results: The study found that the mean diameter of ON was 2.06±0.44 mm, the mean length of right ON was 31.54±4.11 mm, there is no significant different in measurement between males and females (p>0.05), there was strong significant correlation between ON length and diameter with children age (r=0.592**, 0.654**, p<0.001 respectively).Conclusions: The study concluded that there was strong correlation between right and left ON diameter and length with age.


2021 ◽  
Vol 9 (A) ◽  
pp. 47-51
Author(s):  
Sholahuddin Rhatomy ◽  
Kurniawan Silalahi ◽  
Anggaditya Putra ◽  
Nolli Kresonni

BACKGROUND: The patellofemoral join is a unique complex joint formed by articulation of the patella and the femoral trochlea. Normal measures for patellofemoral parameters have been published. AIM: This study aimed to describe the characteristics of patellofemoral measurements in Indonesian population using magnetic resonance imaging (MRI). METHODS: This descriptive total sampling study was conducted from May 2019 to August 2020. The parameters of the measurements in this study include Insall-Salvati ratio, Caton-Deschamps index, trochlear angle, lateral trochlear inclination, TT (tibia tubercle) – TG (trochlear groove) distance, and trochlear depth. The mean results of the measurements were compared with the normal value measurements that are internationally used. RESULTS: A total of 100 normal knees MRI scan from patients consisting of 54 (54%) males and 46 (46%) females, with an average age of 35.09 ± 12.77 (19–60) years old. The average body mass index (BMI) was 28.07 ± 3.0 (22–34). Based on ethnicity, subjects were mostly Javanese (66%), Sundanese (12%), Madura (4%), Minangkabau (7%), and the others (11%). The mean of Insall-Salvati ratio was 1.09 ± 0.17 (0.49–1.60). The mean of Caton-Deschamps index was 0.97 ± 0.16 (0.62–1.64). The mean of trochlear angle was 138.97° ± 119.7 (122°–160°). The mean of lateral trochlear inclination was 20.37° ± 4.56 (11.0°–30.6°). The mean of TT-TG distance was 13.76 ± 5.86 (4.9–41), and the mean of trochlear depth was 5.18 ± 1.87 (1.05–8.6). Those values were within normal range of international values. There were no significant differences between comparison of males and females. CONCLUSION: The means of Insall-Salvati ratio, Caton-Deschamps index, trochlear angle, lateral trochlear inclination, and TT-TG trochlear depth of the Indonesian people were within the international normal range, and higher than other countries’ published measurements.


2019 ◽  
Vol 18 (4) ◽  
pp. 276-279
Author(s):  
Fernando Augusto Dannebrock ◽  
Erasmo de Abreu Zardo ◽  
Marcus Sofia Ziegler ◽  
Carlos Marcelo Donazar Severo ◽  
Joel Abramczuk ◽  
...  

ABSTRACT Objective: To evaluate the lumbar triangular safety zone, its boundaries and its relationship with the dorsal root ganglion through Magnetic Resonance Imaging (MRI). Methods: The boundaries, shape and dimensions of 303 triangular safety zones were analyzed in Tesla 3.0 Magnetic Resonance Imaging (MRI) coronal sections from L2 to L5, including the dorsal root ganglion. Results: The sample consisted of 101 patients with a mean age of 32 years. The height of the triangular safety zone was formed by the lateral edge of the dura mater, the width by the upper plateau of the lower vertebra and the hypotenuse by the corresponding nerve root. The mean dimensions and the area varied according to the level studied. The dorsal root ganglion invaded the dimensions of the triangle in all the images studied. Conclusion: Based on the data and the analyses performed, we concluded that knowledge of the boundaries of the triangular safety zone through MRI increases the safety of minimally invasive procedures in the lumbar spine. Level of evidence I; Diagnostic studies – Investigation of a diagnostic test.


2012 ◽  
Vol 40 (11) ◽  
pp. 2549-2556 ◽  
Author(s):  
Corey A. Wulf ◽  
Rebecca M. Stone ◽  
M. Russell Giveans ◽  
Gregory N. Lervick

Background: Osteochondritis dissecans (OCD) of the capitellum affects young athletes involved in elbow load-bearing activities. Unstable lesions are best managed surgically, although debate remains regarding the optimal method. Arthroscopic treatment allows rapid recovery, but the effect on the articular surface is undetermined. Hypothesis: The clinical outcome after arthroscopic microfracture of stage III/IV capitellum OCD would be successful in terms of return to sport and restoration of function, and there would be some evidence of articular restoration or repair. Study Design: Case series; Level of evidence, 4. Methods: We reviewed records of 10 consecutive adolescent patients (age ≤18 years) with stage III or IV OCD lesions of the capitellum managed with arthroscopic microfracture. The mean age at the time of surgery was 13.9 years (range, 10.8-18.5 years); 7 patients were skeletally immature and 3 were skeletally mature. Pre- and postoperative functional assessment included active range of motion, Mayo Elbow Performance Score (MEPS), and Timmerman/Andrews elbow score. All patients underwent plain radiographic and magnetic resonance imaging (MRI) evaluation at a minimum of 12 months (mean, 27 months; range, 12-49 months) and clinical evaluation at a minimum of 24 months (mean, 42 months; range, 27-54 months) after surgery. Results: The mean range of motion improved in both flexion (135.8°→140.7°, P = .112) and extension (20.4°→–2.2°, P = .005). The mean MEPS (70.5→97, P = .007) and Timmerman/Andrews elbow scores (116.4→193.0, P = .008) improved significantly. magnetic resonance imaging (MRI) evaluation demonstrated an improvement in overall joint congruence and the formation of a reparative articular surface in 8 of 10 (80%) patients. No reoperations or major complications were encountered. Six of 8 patients involved in competitive athletics returned to the same level of participation at an average of 5.1 months. Conclusion: Arthroscopic OCD fragment excision and capitellar microfracture demonstrates good to excellent functional results in short-term follow-up. Follow-up MRI suggests potential for a reparative fibrocartilaginous articular surface. Longer term follow-up is necessary to determine durability of the technique.


2020 ◽  
Vol 101 (3) ◽  
pp. 155-162
Author(s):  
S. A. Chernyad’ev ◽  
V. B. Aretinskiy ◽  
N. I. Sivkova ◽  
A. V. Zhilyakov ◽  
N. Yu. Korobova ◽  
...  

Objective. To determine the magnetic resonance imaging (MRI) morphological features of Baker’s cysts and to assess their correlation with the age of patients.Material and methods. The investigation was based on the assessment of MRI readings in 37 patients with Baker’s cysts; of them there were 29 (78.4%) women and 8 (21.6%) men. The mean age of the examinees was 60.3 years (25 to 82 years).Results. The mean dimensions of the cysts were measured. Their length, width, and height were 34 ± 2.1 mm, 5 ± 1.2 mm (range 4–31 mm), and 58 ± 2.9 mm, respectively. Their mean thickness was 0.7 mm. Intracystic chondral bodies were detected in 3 (7.5%) cases. These parameters were shown to be unrelated to age. It was found that all cysts were multi-chamber and an average of 6.8 chambers was detected. There was a weak, inversely proportional, statistically significant relationship between the age of the patients and the number of chambers in the cyst. The younger participants of the investigation exhibited no meniscal damage in an overwhelming case (57.1%); whereas complete and incomplete meniscal tears much more often occurred in older patients with Baker’s cysts (from 29 (78.4%) to 34 (91.9%) people, respectively).Conclusion. Degenerative bone and cartilage tissue changes in the joint increase with age, regardless of the cyst sizes.


2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Feng Lu ◽  
Zan Chen ◽  
Hao Wu ◽  
Feng-Zeng Jian

Objective. To explore the magnetic resonance imaging (MRI) characteristics of Chiari malformation type I (CMI) in patients with dysphagia. Methods. Adult patients diagnosed with CMI were retrospectively and consecutively reviewed from January 2013 to December 2016. Symptoms and medical characteristics were recorded. According to the clinical manifestations, we divided the patients into two groups. The first group had 21 patients with symptoms of dysphagia and the second group had 71 patients with nondysphagia symptoms. Various length or angle measurements of the posterior cranial fossa (PCF), syringomyelia, and degree of cerebellar tonsillar herniation were investigated using magnetic resonance imaging (MRI). Univariate, correlation, and multivariate logistic regression analyses were used to compare and analyze the data of the two groups. Results. The mean length of the clivus, height of PCF, and slope inclination angle of clivus significantly decreased in the dysphagia group compared to the nondysphagia group. The mean cranial spinal angle (CSA) and degree of cerebellar tonsillar herniation were significantly larger in the dysphagia group. There were no correlations between the age, sex, disease duration, and the length of cerebellar tonsillar herniation or CSA. There was a positive correlation between dysphagia level and CSA (r=-0.50; p=0.021). Among CSA, age, sex, the degree of tonsillar herniation, syringomyelia, and disease duration, CSA was the individual sign that correlated significantly with dysphagia (OR: 1.447; 95% CI: 1.182-1.698; P<0.001). Interactions between CSA and the degree of cerebellar tonsillar herniation, syringomyelia, and dysphagia existed (OR: 1.104; 95% CI: 1.042-1.170; P=0.001 and OR: 1.081; 95% CI: 1.023-1.142; P=0.006, respectively). Conclusions. The CMI patients with dysphagia were more likely to have a large CSA on MRI compared with CMI patients without dysphagia. An increased probability with syringomyelia or length of cerebellar tonsillar herniation can enhance the contribution of CSA to dysphagia in patients with CMI.


2021 ◽  
Vol 9 (3.3) ◽  
pp. 8079-8085
Author(s):  
Suman Gnawali ◽  
◽  
Ajay Kumar Yadav ◽  
Mukunda Psd Humagain ◽  
Prakash Kayastha ◽  
...  

Corpus callosum (CC) is the main fiber tract connecting the cortical and sub-cortical regions of the right, left hemispheres, and plays an essential role in the integration of information between the two hemispheres. By using magnetic resonance imaging (MRI), the dimensions of corpus callosum can be studied. In this cross-sectional quantitative study 80 cases of normal MRI head were selected for study over two months. T1 weighted sagittal spin-echo images with slice thickness of 6 mm, planned from an axial and coronal image were used for measuring length and thickness of corpus callosum. Obtained data were analyzed using SPSS ver.20 software and shown in frequency, percentages and bar diagram. The mean Corpus callosum (CC) length was 68.06 mm in the study population (n=80). The mean thickness of Genu, Body and Splenium were 9.15,5.2 and 9.08 mm respectively and average thickness was 7.81 mm. Statistically significant differences in size of CC for various age groups in both sexes were observed. The mean length of CC was 68.06 mm and mean thickness of CC was 7.81 mm. There were variation in the size of CC with age and sex. The Pearson correlation Coefficient is 0.48829 between Age and Length of CC, its P-value is 0.0019 KEY WORD: Magnetic Resonance Imaging (MRI), Corpus callosum (CC), Genu, Body, Splenium Sagittal Spin-Echo.


2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15166-e15166
Author(s):  
Yazan Fahmawi ◽  
Clayton Smith ◽  
Leander Grimm ◽  
Shikha Khullar ◽  
Paul Rider ◽  
...  

e15166 Background: In patients with locally advanced rectal adenocarcinoma (LARA), the response to neoadjuvant concurrent chemoradiation (NCCR) correlates with long-term outcomes. Neoadjuvant rectal (NAR) score ([5 ypN - 3 (cT - ypT) + 12]2/9.61) is a novel short-term surrogate endpoint for disease free survival (DFS) and Overall survival (OS). The prognostic significance of magnetic resonance imaging (MRI) findings following NCCR is yet to be explored. Here, we evaluated the agreement between post NCCR MRI yT and yN and pathological ypT and ypN. In addition, we calculated the post NCCR MRI NAR (mNAR) score using the MRI yT and yN ([5 yN - 3 (cT - yT) + 12]2/9.61) and explored its prognostic significance. Methods: Between 2014 and 2018, all patients with LARA were identified. Among those, 43 patients received NCCR, had post NCCR MRI and underwent surgical resection. Weighted Kappa was used to measure the agreement between post NCCR MRI yT and yN and pathological ypT and ypN. Paired t-test was used to compare the means between NAR and mNAR scores. NAR and mNAR scores were classified as low ( < 8), intermediate (8-16) and high ( > 16). DFS and OS were analyzed using Kaplan-Meier curves. Results: In our cohort, the agreement was slight between post NCCR MRI yT and Pathological ypT (p = 0.111), and fair between post NCCR MRI yN and pathological ypN (0.278). The mean NAR score was 16 and the mean mNAR score was 20 (p = 0.0079). Low-intermediate and high NAR scores were seen in 31 (72%) and 12 (28%) patients respectively. However, low-intermediate and high mNAR scores were seen in 20 (47%) and 23 (53%) patients respectively. The median DFS in patients with low-intermediate and high NAR scores was not reached and 30 months (p = 0.00063) respectively. The median OS in patients with low-intermediate and high NAR scores was not reached and 40 months (p = 0.00056) respectively. The median DFS in patients with low-intermediate and high mNAR scores was not reached in both groups (p = 0.058). The median OS in patients with low-intermediate and high mNAR scores was not reached in both groups (p = 0.15). Conclusions: Post NCCR MRI yT and yN had slight and fair agreements with ypT and ypN respectively. In our cohort, there was a difference between NAR and mNAR. NAR demonstrated prognostic significance for DFS and OS, while mNAR did not at the time of analysis.


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