Background and Purpose: Dueto motion artifacts, optic nerve (ON) findings of idiopathic intracranial hypertension (IIH) can easily be overlooked on T2-weighted (T2w) turbo spinecho sequence. This study aimed to investigate the contribution of the apparent diffusion coefficient (ADC) map derived from the interleaved multi-shot (IMS) echoplanar imaging (EPI) to the ON findings of IIH in children.Methods: MRIs of 42 pediatric patients aged 3-17 years diagnosed with definite IIH according to modified Dandy criteria were retrospectively re-evaluated, between April 2018 and January 2021. Forty-two age-and sex-matched subjects with no IIH symptoms and reported as normal were included as a control group.Results: ON sheath distance (ONSD) on the ADC map (p = .005) and vertical tortuosity (p = .030) were significant single MRI parameters for predicting IIH. Other single parameters were not statistically significant. Flattening of the posterior sclera (FPS) and ON protrusion (ONP) were observed on ADC maps more frequently than T2w (42.8% vs. 19% and 19% vs. 4.7%, respectively). From combined MRI parameters, the presence of at least one of ONP, FPS, or ONSD on ADC maps (p = .001) showed greater significance than the presence of T2w (p = .048). The predictive values of other MRI findings evaluated together were not statistically significant (p > .05).Conclusions: This study's results show that due to the short readout time and less sensitivity to motion, the ADC map obtained from IMS-EPI can contribute to orbital findings of IIH, in addition to T2w.

Multisystem inflammatory syndrome in children (MIS-C) develops as an exaggerated, complex, postinfectious immune response related to severe acute respiratory syndrome coronavirus (SARS-CoV-2 virus), which affects all systems in the body. Cardiac involvement in children can have a spectrum ranging from mild disease to severe heart failure due to fulminant myocarditis. Cardiac involvement usually resolves after clinical recovery. However, the adverse effect of myocarditis on cardiac function after recovery is not fully known. In this study, we aimed to investigate cardiac involvement by performing cardiac magnetic resonance imaging (MRI) after acute and recovery stage. Here, we describe the clinical and laboratory features and the effect of treatment on the development of fibrosis on cardiac MRI in 21 patients with MIS-C and the localization of fibrosis in five patients.When compared with 16 patients with normal cardiac MRI, five patients with cardiac fibrosis on MRI had a greater age (mean 14.4 ± 4.0 years vs 8.9 ± 3.5 years; p=0.007), a similar gender distribution (male/female: 3/2 vs 5/11; p= 0.325), a greater body mass index (BMI) (mean 22.68±4.48 kg/m2 vs 17.73±3.15 kg/m2;p=0.012), a lower leucocyte count, [median 5250/μl (3880-7790) vs 12065/μl (4210-21210); p=0.011], a lower neutrophil count [median 4000/μl (2150-6560) vs 9875/μl (2540-18500); p=0.019], a higher blood urea nitrogen level [median 15 mg/dL (11-26.8) vs 8.5 mg/dL (4-18); p=0.025], and a higher creatinine level (mean 0.61±0.07 mg/dL vs 0.45±0.14 mg/dL; p= 0.024). Cardiac fibrosis on MRI was located in the region of posterior right ventricle insertion point and in the midventricular septum.ConclusionsAdolescence and obesity appear as risk factors for the development of fibrosis as a late-term sequela of myocarditis. We believe that other mechanisms such as a complex immune system response and hemodynamic instability causing acute kidney injury may similarly play a role for the development of cardiac fibrosis. However, this subject should be clarified by more comprehensive studies. Furthermore, future studies reporting the follow-up data of patients with fibrosis are necessary to predict and manage adverse outcomes.

Background. Cardiac involvement in multisystem inflammatory syndrome in children may have a spectrum ranging from mild disease to severe heart failure due to fulminant myocarditis. Cardiac involvement usually resolves after clinical recovery. However, the adverse effects of myocarditis on cardiac function after recovery are not fully known. This study aims to investigate cardiac involvement by performing cardiac magnetic resonance imaging (MRI) after the acute and recovery periods. Methods. 21 patients with clinical and laboratory signs of myocarditis, including left ventricular systolic dysfunction, mitral regurgitation, elevated troponin T, elevated N-terminal pro-B-type natriuretic peptide and electrocardiographic changes, who had given consent for cardiac MRI, underwent cardiac MRI after completion of the acute and recovery phases. Results. When compared to 16 patients with normal cardiac MRI, five patients with cardiac fibrosis on MRI were older, had greater body mass indexes, lower leucocyte counts, lower neutrophil counts, higher blood urea nitrogen levels and higher creatinine levels. Cardiac fibrosis on MRI was located in the posterior right ventricle insertion point and in mid ventricular septum. Conclusions. Adolescence and obesity appear as risk factors for the development of fibrosis as a late-term sequela of myocarditis. Furthermore, future studies reporting the follow-up data of patients with fibrosis are necessary to predict and manage adverse outcomes.