فهرست مطالب

Iranian Journal of Radiology
Volume:18 Issue: 1, Jan 2021

  • تاریخ انتشار: 1399/12/06
  • تعداد عناوین: 18
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  • Pengfei Chen, Na Fan, Yi Liang, Wenhui Fan * Page 1
    Background

     As the coronavirus disease 2019 (COVID-19) epidemic continues to spread, it is important to predict the clinical classification of COVID-19 and evaluate the progression of lung injury.

    Objectives

     To investigate the predictive factors of the outcome of moderate-stage coronavirus disease 2019 (COVID-19) and maximal extent of lung injury.

    Patients and Methods

     This study was a retrospective analysis of 97 patients with moderate-stage COVID-19 diagnosed in our hospital. We divided the patients into two groups according to disease progression: one group for moderate stage and another for both severe stage and critically severe stage COVID-19. We then analyzed the independent factors influencing changes in the course of the disease in moderate-stage patients using binary logistic regression. Next, we assessed the computed tomography (CT) score of maximal lung injury using follow-up images of the patients. We used multiple linear regression (MLR) to analyze the independent variables, and to predict the CT score of maximal lung injury in COVID-19 patients.

    Results

     The results were obtained using multivariate logistic regression analysis, and the independent factors affecting clinical classification were baseline CT score (P = 0.008), high-sensitivity C-reactive protein (hs-CRP) (P = 0.001), and diabetes (P = 0.04). MLR revealed that the factors predicting the extent of maximal lung injury in COVID-19 patients were age (P = 0.014), neutrophil percentage (P = 0.038), lymphocyte percentage (P = 0.031), hs-CRP (P = 0.010), and baseline CT score (P < 0.001). The optimal cut-off value of hs-CRP was 18.5, and the baseline CT score was 8.5.

    Conclusion

     Age, baseline CT score, hs-CRP, neutrophil percentage, and lymphocyte percentage could predict the CT score of maximal lung injury, and hs-CRP > 18.5, baseline CT score ≥ 9, and diabetes were independent factors of severe/critically severe COVID-19.

    Keywords: Diabetes Mellitus, C-Reactive Protein, COVID-19, Acute Lung Injury
  • Kadir Oymen Hancerliogullari, Alptekin Tosun * Page 2
    Background

     Necrotizing enterocolitis (NEC) is among the most common and destructive diseases in the neonatal period. Imaging methods are important in the early diagnosis and treatment of such diseases. Ultrasound elastography (USE) is a fast and non-invasive imaging technique that deals with the viscoelastic properties of tissues.

    Objectives

     The purpose of this study is to assess the effectiveness of USE, which determines tissue stiffness with grayscale and colored images, as an imaging tool in the diagnosis and treatment of NEC.

    Materials and Methods

     Sixteen newborn Wistar albino gender rats were separated into two groups including eight rats each. The first group (G-I) was taken as a control group and was not exposed to any intervention. The second group (G-II) was exposed to 100% CO2 for 5 minutes and 4°C for 10 minutes. All these interventions were applied twice per day for 4 days. We observed elastographic data at 24, 48, and 96 hours. All rats were sacrificed on the fourth day. The combination of gray-scale US and elastography was performed by a 4-13 MHz with an average of 12 MHz bandwidth linear probe in Esaote Ultrasonography Systems, MyLab60 model, produced in Geneva, Italy; with ElaXto imaging application.

    Results

     Statistically significant differences were detected in elastosonography ratios of terminal ileum at 24, 48, and 96 hours (P < 0.05). As ischemia period in NEC was prolonged, elastosonographic ratios of intestinum increased significantly.

    Conclusion

     It was found that USE is a reliable technique with superior features in the assessment of the terminal ileum in the neonatal age group. It is due to its wide image window and better assessment of tissue stiffness with gray scale and color image.
    It has been observed that the USE technique is helpful in the diagnosis.

    Keywords: Necrotizing Enterocolitis, Elastography, Tissue Stiffness
  • Xiao Rong Fu, Juan Xu, Guang Yao Wu *, Qing Feng Xiong Page 3
    Background

     In-stent restenosis (ISR) usually develops from stent neointimal hyperplasia (SNH), which will seriously weaken the effect of treatment. In this study, both SNH and ISR were classified as in-stent stenosis (ISS), and a non-invasive parameter – myocardial blood flow index (MBFI) was used to analyze its value in the diagnosis of stent abnormalities.

    Objectives

     Analyzing the application of MBFI in the diagnosis of ISS.

    Patients and Methods

     Clinical follow-up data for 572 patients with drug-eluting stent (DES) was collected continuously. Ninety cases were screened with the protocol of computed coronary tomography angiography (CCTA) and invasive coronary angiography (ICA) for the unrelieved symptoms. In-stent abnormalities included SNH (ISS < 50%) and ISR (ISS ≥ 50%). The ROC curve was analyzed using the optimal cutoff value of MBFI to evaluate the in-stent abnormalities. t-test of independent samples was used for the comparison data with normal distribution, and chi-square test was used for comparison of nominal variables P < 0.05 was considered statistically significant.

    Results

     Frequency of ISS was not statistically different between genders (χ2 = 0.105) (P = 0.7463). The optimal cutoff value was 0.082 with the area under the curve (AUC) of 0.829 (P < 0.001). The sensitivity, specificity, positive predictive value, and negative predictive value were 91.4%, 89.1%, 84.2%, and 94.2%, respectively, and the accuracy was 90.0%. Among 39 cases with MBFI ≤ 0.082, 34 (87.18%, 34/39) were with ISS, including 18 (20%, 18/90) of SNH, and 16 (17.9%, 16/90) of ISR. In the 39 cases with MBFI ≤ 0.082, there were eight (20.5%, 8/39) presented new lesions, and seven (17.9%, 7/39) presented severe lesions.

    Conclusion

     MBFI could be used for evaluating ISS, and more attention should be paid to the new accompanying lesions for the high risk of severe lesions.
     

    Keywords: Coronary Artery Disease, Coronary CT Angiography, Invasive Coronary Angiography, In-Stent Stenosis, Myocardial Blood Flow Index, Diagnosis Test
  • Seyed Ali Alamdaran *, Ali Abdollahi, Ali Feyzi, Farideh Jamali Behnam, Mehdi Yousefzadeh Talfavani, Mehdi Fathi, Ali Azadmand, Marjan Joudi, Mehdi Parvizi Mashhadi, Maryam Tayebi Meybodi, Alireza Sabzevari Page 4
  • Xiaolong Liu, Zhanguo Sun, Xiaoqiang Wang, Yueqin Chen, Linsheng Wang, Lizhi Yu, Huiling Yan, Minxia Pang, Jiehuan Wang * Page 5
    Background

     Chest computed tomography (CT) is a recommended screening and assessment tool for patients with suspected coronavirus disease (COVID-19). However, CT units are currently not available in many temporary hospitals and centralized isolation places.

    Objectives

     To delineate the workflow of mobile CT unit and evaluate its role in screening for COVID-19 infection in temporary hospitals and centralized isolation locations.

    Patients and Methods

     Two hundred and twenty-three patients under medical observation in temporary centralized isolation were enrolled in this study. All patients underwent reverse-transcription polymerase chain reaction (RT-PCR) testing and mobile CT chest examinations. Communication, storage, and browsing of CT data were performed with 4G and cloud technology. Image quality and radiation dose were evaluated and compared with a commercial conventional 64-row CT scanner. Additionally, the sensitivity of initial chest CT and the initial RT-PCR for COVID-19 were compared.

    Results

     CT examination of 223 patients was completed within 19 work hours. Communication, storage, and browsing of CT data via 4G and cloud technology were seamless. There were no significant differences in subjective image quality scores between groups (P > 0.05). COVID-19 pneumonia was eventually confirmed in 49 patients (21.97%). The sensitivity of initial chest CT was greater than that of the initial RT-PCR (85.71% and 67.35%, respectively) (P < 0.05).

    Conclusion

     Screening suspected patients for COVID-19 by mobile CT in temporary hospitals and isolation points is a simple, efficient, and highly sensitive technique for early diagnosis and control of COVID-19.

    Keywords: Diagnostic Value, Reverse Transcription Polymerase Chain Reaction, Coronavirus Disease, Mobile CT, Chest CT Imaging
  • Xiaoqiang Wang, Zhengtong Wang, Zhanguo Sun *, Yueqin Chen, Wenwen Zhao, Xiaolong Liu, Zhongsheng Zhang, Wenheng Qin, Xiang Guo, Weiwei Wang, Wei Liu Page 6
    Background

     Early differential diagnosis of coronavirus disease 2019 (COVID-19) and Mycoplasma Pneumonia (MP) are hampered by non-specific symptoms, the lack of rapid responding laboratory measures and the presence of family aggregation. Chest computed tomography (CT) plays a significant role to detect the distribution, density and morphology of lesions caused by either COVID-19 or MP.

    Objectives

     To compare the symptoms, laboratory parameters, and chest CT results of adults with COVID-19 and MP and to assess the use of these findings in the differential diagnosis of these diseases.

    Patients and Methods

     The initial clinical manifestations, laboratory results, and chest CT findings of 45 adult patients with COVID-19 (COVID-19 group) and 55 adult patients with MP (MP group) were reviewed retrospectively. All of the patients were diagnosed in the public hospitals in the epidemic area from 20 January to 28 February 2020.

    Results

     Muscle ache and fatigue were more frequently present in the COVID-19 group (P = 0.009 and 0.029, respectively). Increased procalcitonin levels were more common in the MP group (P = 0.001). The chest CT results indicated that bilateral lung involvement, ground glass opacities, “crazy-paving” patterns, and air bronchogram signs were more common in the COVID-19 group (P < 0.001 for all), respectively. However, single lobe involvement, pulmonary consolidations, lobular central nodules, generalized bronchial wall thickening with luminal stenosis, and bronchial mucus impaction were more common in the MP group (P < 0.001 for all). Receiver operating characteristic analysis of a model established using CT parameters indicated a good or excellent performance in distinguishing COVID-19 from MP.

    Conclusion

     COVID-19 and MP have similar clinical manifestations and laboratory results in early stage. However, the chest CT findings are valuable in the differential diagnosis of these two diseases, particularly in patients from COVID-19 epidemic areas.

    Keywords: Mycoplasma Pneumonia, Tomography, Differential diagnosis, Coronavirus Disease 2019, X-Ray Computer
  • Xianwen Hu, Xiaolan He, Pan Wang, Yujia Zou, Dandan Li, Jiong Cai* Page 7

    Malignant triton tumor (MTT) is a rare, aggressive type of tumor that commonly originates from mesenchymal tissue and is mainly found in adults. Herein, we report a single case of a 12-year-old boy diagnosed with intracranial MTT. This report presents the clinical features and imaging findings of MTT. The 12-year-old patient consulted the hospital due to intermittent dizziness and headache. Computed tomography (CT) showed low-density space-occupying lesion in the left parietal fossa. Magnetic resonance imaging (MRI) showed a mass shadow with slightly long T1 and long T2 signal intensity in the same area. Contrast enhanced MRI (CE-MRI) showed obvious enhancement of the lesion. He was diagnosed with meningioma and underwent surgery. Postoperative histopathological examination diagnosed the lesion as MTT. Two months after the operation, CT examination showed tumor recurrence. He then underwent local radiotherapy and chemotherapy, and unfortunately, died six months later. Intracranial MTT should be considered as one of the differential diagnoses of intracranial meningiomas. CT and MRI are of great significance in the identification of lesion location, invasion range, and degree of malignancy. Final diagnosis of intracranial MTT requires histopathological examination. MTT has a poor prognosis, and surgical resection of the tumor is the preferred treatment. Intervention after early diagnosis is the key to improve the outcome of patients.

    Keywords: Children, Intracranial, Case Report, Malignant Triton Tumor
  • Xuechao Du, Pengtao Sun, Yuan Zhao Yuchang Yan, Zhenyu Pan* Page 8

    The pulmonary type of primary small cell carcinoma of the ovary (SCCOPT) is a rare aggressive malignancy with a poor prognosis, usually occurring in postmenopausal women. Few literatures have emphasized on the magnetic resonance (MR) imaging features. In this paper, we analyze its MR imaging findings in combination with pathological manifestations. We report a case of a 51-year-old woman who presented with abdominal pain and distension. Several tumor markers were elevated. MR scan of the pelvis was performed. It revealed a heterogeneous lobulated mass with solid and cystic components originating from the right adnexa. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. Histology showed a tumor comprising areas of classical small-cell carcinoma, and SCCOPT was diagnosed based on histopathology and immunohistochemistry. SCCOPT is a rare aggressive malignancy with certain characteristic imaging features. The solid component exhibits slightly higher signal on T2-weighted imaging with fat suppression, restricted diffusion on diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) maps, and honeycomb-like persistent enhancement. More data are needed to better understand its specific imaging manifestations.

    Keywords: Magnetic Resonance Imaging, Case Report, Ovary S, mall Cell Carcinoma, Pulmonary Type
  • Mustafa Bozdağ *, Recep Savas Page 9

    Shortly after being identified in China, 2019 coronavirus disease (COVID-19) caused by SARS-CoV-2 has spread rapidly and millions of people were infected as of May 2020; the outbreak resulting in more than 250,000 deaths was declared a pandemic. In this critical stage of the ongoing pandemic of COVID-19, information regarding the long term effects of the disease remains limited. While most of the patients recover completely, some patients may develop complications. In this report, we aimed to present the serial chest high-resolution computed tomography (HRCT) findings in a patient who developed pulmonary fibrosis (PF) similar to usual interstitial pneumonia (UIP) pattern during recovery from severe novel coronavirus pneumonia.

    Keywords: Fibrosis, Computed Tomography, Pneumonia, Coronavirus, COVID-19
  • Huanan Zhang, Chaochao Wang, Yuan Zhang, Shaohua Xu, Ying Wang, Wei Wang* Page 10
    Background

    Lung cancer is not only the most common tumor, but also the tumor of supreme incidence and death rate in all malignant tumors. Bronchoscopy has been widely used in the diagnosis of space occupying lung lesions, but the diagnostic rate of pulmonary peripheral lesions (PPL) is relatively low. The emergence of intra-airway ultrasound technology is a milestone for the development of respiratory endoscopy technology. The appearance of miniature lung ultrasound probe has greatly improved the accuracy of diagnosis of peripheral lung diseases, especially peripheral lung cancer. In recent years, guided sheath (GS) endobronchial ultrasonography with trans-bronchial lung biopsy (EBUS-TBLB) has been used to diagnose pulmonary peripheral lesions. The diagnostic rate is over 70%, and the incidence of adverse reactions is low.

    Objectives

    The aim of the current study was to determine the diagnostic value of endobronchial ultrasonography with a guide sheath combined with virtual bronchoscopic biopsy (EBUS-GS-TBLB+VB) for PPL, and to find the factors that were correlated with greater diagnostic accuracy of EBUS-GS-TBLB. Patients and

    Methods

    In this retrospective study, 87 patients with PPL were grouped according to different instrument-guided TBLB techniques, which included conventional TBLB, EBUS-GS-TBLB (E-TBLB), and EBUS-GS-TBLB+VB (E+V-TBLB). The diagnostic accuracy and duration of the operations were compared. Correlative factors were determined and any complications related to the operations were recorded.

    Results

    The diagnostic accuracy of E+V-TBLB (16/20, 80%) and E-TBLB (22/29, 75.9%) were significantly better (P < 0.05) than that of TBLB (18/38, 47.4%), and the duration of the operation (minutes) was significantly shorter in E+V-TBLB (7.78 ± 2.0) than in E-TBLB (12.97 ± 3.4) (P = 0.018). We found that lesions with a diameter ≥ 2 cm (27/29, 93.1%) that were probe-penetrable (30/32, 93.5%), and with a computed tomography (CT) attenuation value > 20 HU were related to higher diagnostic accuracy in EBUS-GS-TBLB. All the patients tolerated the TBLB operations well. Bleeding occurred in one patient from the TBLB group. There was no pneumothorax, hemoptysis, or other complications in the other groups.

    Conclusion

    The diagnostic accuracy of EBUS-GS-TBLB was much greater than that of TBLB, and patients showed better tolerance to it.

    Keywords: Bronchoscopy, Ultrasonography, Biopsy, Peripheral Pulmonary Lesion, Virtual Bronchoscopy
  • Na Yeon Han, Deuk Jae Sung, *, Min Ju Kim, Beom Jin Park, Ki Choon Sim, Seok Ho Kang Page 11
    Background

    Adherent perinephric fat affects operative complexity during partial nephrectomy (PN) and it could be predicted using computed tomography (CT) based on the Mayo adhesive probability (MAP) score.

    Objectives

    To investigate reproducible measurement methods of perinephric fat with comparison of two tailored methods for measurement of posterior perinephric fat thickness (PPFT) on preoperative CT and examine the association between the methods and operative complexity in PN. Patients and

    Methods

    This cross-sectional study included 72 consecutive patients who underwent robotic-assisted or open PN. The data on operative time, ischemia time, and pathologic results were obtained. Two radiologists independently assessed PPFT based on the MAP system in the first session, and subsequently by using two tailored methods in the second session and scored for perinephric fat stranding. The nephrometry scoring system was used for stratifying the complexity of renal masses. Multiple linear regression was used to evaluate the determinants of operative time and ischemia time.

    Results

    For measurement of PPFT, intraclass correlation coefficients between the reviewers using two detailed methods showed no statistical difference (P = 0.173) but were significantly higher than the coefficients scored in the first session (P < 0.001). Nephrometry score was a determinant of ischemia time (P < 0.001 and 0.001 for two reviewers) and PPFT was identified as a determinant of operative time (P≤0.023 in all the analysis using two differentmethods for both the reviewers) in robotic-assisted PN. Nephrometry score was identified as a determinant of ischemia time in open PN as per one of the reviewers (P = 0.006).

    Conclusion

    The tailored methods presented herein were more reproducible than the MAP score and demonstrated that increased PPFT was related to longer operative time in robotic-assisted, and not in open PN.

    Keywords: Nephrectomy, Multidetector Computed Tomography, Kidney Neoplasm, Intra-abdominal Fat
  • Xia Zhang, Tao Gong, Shuhui Yuan, Guangbin Wang* Page 12
    Background

    T2* mapping is a reliable tool in articular cartilage imaging. It has been widely used to evaluate the degeneration of knee joint and intervertebral discs. Degenerative joint disease of pubic symphysis is the primary cause of groin pain during late pregnancy.

    Objectives

    To evaluate the alterations of pubic symphyseal cartilage during late pregnancy using T2* mapping. Patients and

    Methods

    Sixty-one first-pregnancy women, 48 second-pregnancy women and 64 nulliparous women were enrolled in this case-control study. All subjects underwent MRI exam of the pubic symphysis on a 1.5T MR scanner, including T2* mapping sequence. Regions of interest (ROIs) were hand-drawn on T2* maps along the left and right side of the cartilage and anterior/middle/posterior sub-regions of each side. T2* values were analyzed and compared among the three groups using analysis of variance. The average pubic symphyseal width was measured. The correlation between pubic symphyseal width and T2* values of cartilage were analyzed using Pearson’s correlation coefficient.

    Results

    Compared with nulliparous women, T2* values increased significantly in late pregnancy in the left/right cartilage of pubic symphysis. The differences were mainly driven by the posterior sub-region; while, no differences were found between women during first and second pregnancies. The positive linear correlation between symphyseal width and mean T2* values of the cartilage was only seen in the group of women during first pregnancy, with no significant linear correlation in the other two groups.

    Conclusion

    T2* mapping is a sensitive quantitative method capable of detecting changes in the pubic symphyseal cartilage related to pregnancy, and the T2* values increased significantly during late pregnancy.

    Keywords: Pubic Symphysis, Magnetic Resonance Imaging, Pregnancy, Cartilage
  • Fatemeh Zamani *, Afshar Ghamari, Gisoo Darban Hosseini Amirkhiz, Neda Pak, OmidGhaemi Page 13

    Our objective was to evaluate clinical and computed tomographic features in hospitalized children with COVID-19 infection who were admitted to the pediatric center of excellence, children’s medical center. In this case-series, we report twelve patients with clinical symptoms of acute respiratory infections at the beginning or after admission who have PCR-proved (throat swab samples) COVID-19 infection and underwent computed tomography imaging. Six patients had an underlying disease and atypical findings with no clinical suspicion at the beginning. Tachypnea (75%) represented the most common physical finding. Computed tomography was abnormal in 83.3% of patients. Subpleural consolidation, peribronchial thickening, round consolidation, and Halo sign was depicted. The empirical regimen in our hospital included hydroxychloroquine and oseltamivir. Some of the patients managed easily, but others had prolonged hospital stay, especially patients with significant underlying conditions.

    Keywords: COVID-19, Pediatric, Computed Tomography, Clinical Features
  • Ugur Kesimal *, Kamil Karaali, Utku Senol Page 14
    Background

    The central tegmental tract (CTT) is an extrapyramidal tract between the red nucleus and the inferior olivary nucleus which is part of the Guillain-Mollaret triangle (dentato-rubro-olivary system). Symmetric central tegmental tract hyperintensity (CTTH) is a pediatric brain magnetic resonance imaging (MRI) finding with an unclear clinical and radiological significance.

    Objectives

    The aim of this retrospective study is to determine the radiological significance of CTTH on magnetic resonance imaging (MRI) in children. Patients and

    Methods

    Pediatric patient’s MRI from January 2015 to January 2017 were retrospectively reviewed in this case series study. Patient records with presence of CTTH in their MRI were evaluated.

    Results

    There were 39 out of 2981 brain MRIs with CTTH with a prevalence of 1.3%. Some CTTH lesions disappeared on follow-up. In two patients, the disappearance of CTTH temporally corresponded to clinical improvement. Also we had patients with hemolytic uremic syndrome, autoimmune hemolytic anemia, Wilson’s disease, combined immunodeficiency, Bartter syndrome, and autism.

    Conclusion

    CTTH could be caused by a physiological maturation process or a physiological response of the cells in the central tegmental tract to a more widespread toxic/metabolic or ischemic insult in the brain. CTTH also appears to have a transient nature in some cases. Further research elucidating the pathophysiology of CTTH is needed.

    Keywords: Central Tegmental Tract Hyperintensity, Children, Magnetic Resonance Imaging, Epilepsy, Metabolic Disease
  • Niloofar Ayoobi Yazdi, Faeze Salahshour *, Habibollah Dashti, Masoomeh Safaei, Selda Behestani, Moneereh Moayeri, Mehran Arab Ahmadi Page 15

    Hydatid cyst is one of the predominantly cystic liver lesions and is also a zoonotic disease that is highly endemic in the Mediterranean region. This condition has extensive differential diagnoses, such as hepatic mesenchymal hamartoma, a rare benign hepatic tumor, which commonly occurs in infants and children, and is extremely rare in adults. Its imaging findings vary from a cystic tumor to a solid mass occupying one or both lobes of the liver. We report an unusual case of a purely cystic mesenchymal hamartoma of the liver in a 60-year-old female patient. The patient had been treated with albendazole for several years; however, the final histopathology revealed mesenchymal hamartoma.

    Keywords: Ultrasound, Hydatid Disease, Cystic Lesions, Liver Mesenchymal Hamartoma
  • Won Jae Choi, Yun Sun Choi *, Yoon Young Jung, Joo Young Kim, Min Sung Kim, Jin Woo Kim Page 16

    The most common sites for metastasis of lung cancer are the bones, liver, adrenal glands, and brain. Only a few studies have reported on perianal or perirectal metastasis of lung cancer. Herein, we report the case of a 78-year-old man who developed distant perianal metastasis of small cell lung carcinoma (SCLC), presenting as a palpable mass and pain in the buttock, diagnosed through magnetic resonance imaging. Immunohistochemical staining confirmed perianal metastasis from SCLC. It is important to be aware of this uncommon manifestation of lung cancer, which will help in early diagnosis and proper treatment.

    Keywords: Magnetic Resonance Imaging, Metastasis, Small Cell Lung Carcinoma, Perianal
  • Fariba Zarei, Mahdi Saeedi-Moghadam, Banafsheh Zeinali-Rafsanjani *, Hannaneh VahabAghaie Page 17
  • Edis Çolak* Page 18
    Background

    The pyramidal lobe (PL) is a common anatomic variation of the thyroid gland with a reported prevalence of over 50% in adult series, but to the best of our knowledge, there are no data in the literature regarding its characteristics in the pediatric population.

    Objectives

    The aim of this study was to evaluate the prevalence, anatomic, and morphological features of the PL in pediatric participants on thyroid ultrasonography (US).

    Methods

    The descriptive cross-sectional study design was used. Between November 2018 and January 2020, the US images obtained from 325 participants with normal thyroid glands were retrospectively evaluated. The presence, location, size, volume, the morphology of the base, and continuity or separation from the thyroid gland were noted for each PL.

    Results

    The PL was present in 34.1% (110/325) of the pediatric participants. It was more frequent in girls than in boys. In all, 56.4% were found to originate from the left of the midline of the isthmus. One patient had double PL. The mean anteroposterior, transverse, and longitudinal diameters were 2.5 ± 1.4, 2.7 ± 1.3, and 5.6 ± 2.5 mm, respectively. The median volume of the PL was 15.11 mm3 . PL was longer in girls compared to boys; however, these changes were not significant (5.8 vs. 5.1, P = 0.406, respectively). A total of 63.6% of the PLs were with a wide base and narrow apex, and 36.4% were with a thin base size the same as the apex size. A separation of the PL from the thyroid was not observed.

    Conclusion

    The present study showed, for the first time, that the age of the children is positively correlated with the size and volume of the PL. The prevalence and location of the PL were consistent with those reported in the adult population.

    Keywords: Thyroid Gland, Thyroid Ultrasonography, Pyramidal Lobe, Prevalence