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Pediatric Radiology

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https://www.readbyqxmd.com/read/28108797/diagnostic-utility-of-intravenous-contrast-for-mr-imaging-in-pediatric-appendicitis
#1
Gray R Lyons, Pooja Renjen, Gulce Askin, Ashley E Giambrone, Debra Beneck, Arzu Kovanlikaya
BACKGROUND: Magnetic resonance imaging (MRI) is increasingly employed as a diagnostic modality for suspected appendicitis in children. However, there is uncertainty as to which MRI sequences are sufficient for safe, timely and accurate diagnosis. Several recent studies have described different MRI protocols, including exams both with and without the use of intravenous contrast. OBJECTIVE: We hypothesized that intravenous contrast may be useful in some patients but could be safely omitted in others...
January 21, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28108796/a-clinical-decision-rule-for-the-use-of-ultrasound-in-children-presenting-with-acute-inflammatory-neck-masses
#2
Farahnaz Golriz, George S Bisset, Beth D'Amico, Andrea T Cruz, Kiyetta H Alade, Wei Zhang, Lane F Donnelly
OBJECTIVE: To identify the association between clinical and ultrasound findings and surgical drainage in children with inflammatory neck masses and to create a clinical decision rule that allows for reduction of unnecessary use of ultrasound in inflammatory neck masses. MATERIALS AND METHODS: We reviewed data on patients ≤18 years who visited our emergency department between 2012 and 2014 with inflammatory neck swelling and who underwent ultrasound examinations of the neck...
January 21, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28102454/muscle-mri-in-pediatrics-clinical-pathological-and-genetic-correlation
#3
Claudia P Cejas, Maria M Serra, David F Gonzalez Galvez, Eliana A Cavassa, Ana L Taratuto, Gabriel A Vazquez, Mario E L Massaro, Angeles V Schteinschneider
Pediatric myopathies comprise a very heterogeneous group of disorders that may develop at different ages and affect different muscle groups. Its diagnosis is sometimes difficult and must be confirmed by muscle biopsy and/or genetic analysis. In recent years, muscle involvement patterns observed on MRI have become a valuable tool, aiding clinical diagnosis and enriching pathological and genetic assessments. We selected eight myopathy cases from our institutional database in which the pattern of muscle involvement observed on MRI was almost pathognomonic and could therefore contribute to establishing diagnosis...
January 19, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28102453/intravascular-ultrasound-versus-digital-subtraction-angiography-direct-comparison-of-intraluminal-diameter-measurements-in-pediatric-and-adolescent-imaging
#4
Anne E Gill, Tadi Ciszak, Hayley Braun, C Matthew Hawkins
BACKGROUND: Intravascular ultrasound (IVUS) allows intraluminal imaging of blood vessels rather than the one-dimensional luminal outline depicted by digital subtraction angiography (DSA). Despite extensive literature in multiple adult vascular diseases, IVUS has not been directly compared to DSA in pediatric and adolescent vascular pathologies. OBJECTIVE: The purpose of this manuscript is to compare absolute luminal diameter measurements obtained via IVUS and DSA during a variety of pediatric endovascular procedures...
January 19, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28101593/diffuse-phalangeal-signal-abnormality-on-magnetic-resonance-imaging-phalangeal-microgeodic-disease
#5
Rupa Radhakrishnan, Kathleen H Emery, Arnold C Merrow
BACKGROUND: Phalangeal microgeodic disease is a rare and benign self-limited condition involving the phalanges, often in the setting of cold exposure, with characteristic MR imaging abnormalities. Radiographic case descriptions are predominantly from Asia and Europe, with only seven cases using MR to characterize phalangeal microgeodic disease. OBJECTIVE: In this study we describe the MR imaging appearance of unusual and striking phalangeal signal abnormality compatible with phalangeal microgeodic disease at our institution in North America...
January 18, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28091700/computed-tomography-localization-of-the-appendix-in-the-pediatric-population-relative-to-the-lumbar-spine
#6
John Davis, Albert T Roh, Matthew B Petterson, Tammy R Kopelman, Samantha L Matz, Daniel G Gridley, Mary J Connell
BACKGROUND: Computed tomography (CT) is commonly used to evaluate suspected acute appendicitis. Although very effective, CT uses ionizing radiation, exposing patients to an increased risk of cancer. OBJECTIVE: This study assessed the potential for decreasing the field of view of the CT (and therefore the dose to the patient) in the evaluation of suspected acute appendicitis in children. MATERIALS AND METHODS: This study was a retrospective review of prospectively collected data from 212 consecutive patients who underwent CT for suspected acute appendicitis...
January 14, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28091699/musculoskeletal-mri-findings-of-juvenile-localized-scleroderma
#7
Eric P Eutsler, Daniel B Horton, Monica Epelman, Terri Finkel, Lauren W Averill
BACKGROUND: Juvenile localized scleroderma comprises a group of autoimmune conditions often characterized clinically by an area of skin hardening. In addition to superficial changes in the skin and subcutaneous tissues, juvenile localized scleroderma may involve the deep soft tissues, bones and joints, possibly resulting in functional impairment and pain in addition to cosmetic changes. OBJECTIVE: There is literature documenting the spectrum of findings for deep involvement of localized scleroderma (fascia, muscles, tendons, bones and joints) in adults, but there is limited literature for the condition in children...
January 14, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28084504/quality-of-pediatric-abdominal-ct-scans-performed-at-a-dedicated-children-s-hospital-and-its-referring-institutions-a-multifactorial-evaluation
#8
Aisling Snow, Carly E Milliren, Dionne A Graham, Michael J Callahan, Robert D MacDougall, Richard L Robertson, George A Taylor
BACKGROUND: Pediatric patients requiring transfer to a dedicated children's hospital from an outside institution may undergo CT imaging as part of their evaluation. Whether this imaging is performed prior to or after transfer has been shown to impact the radiation dose imparted to the patient. Other quality variables could also be affected by the pediatric experience and expertise of the scanning institution. OBJECTIVE: To identify differences in quality between abdominal CT scans and reports performed at a dedicated children's hospital, and those performed at referring institutions...
January 13, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28083700/mri-usage-in-a-pediatric-emergency-department-an-analysis-of-usage-and-usage-trends-over-5%C3%A2-years
#9
Meir H Scheinfeld, Jee-Young Moon, Michele J Fagan, Reubin Davoudzadeh, Dan Wang, Benjamin H Taragin
BACKGROUND: Magnetic resonance imaging (MRI) usage has anecdotally increased due to the principles of ALARA and the desire to Image Gently. Aside from a single abstract in the emergency medicine literature, pediatric emergency department MRI usage has not been described. OBJECIVE: Our objective was to determine whether MRI use is indeed increasing at a high-volume urban pediatric emergency department with 24/7 MRI availability. Also, we sought to determine which exams, time periods and demographics influenced the trend...
January 12, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28062934/focused-ct-using-a-height-adjusted-metric-and-the-umbilicus-as-a-landmark-for-children-undergoing-evaluation-for-appendicitis
#10
Suzanne Roberts, Abigail F Nixon, James A Meltzer, Einat Blumfield
BACKGROUND: Confirmation of appendicitis in children often requires CT. A focused CT scan that is limited to the lower abdomen/pelvis might help to reduce radiation exposure. OBJECTIVE: To determine the position of the appendix relative to the umbilicus and derive a height-adjusted threshold for a focused CT that would identify most appendices. MATERIALS AND METHODS: We conducted a retrospective study of children younger than 18 years who underwent a CT scan for suspected appendicitis...
January 6, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28058484/hoverboards-spectrum-of-injury-and-association-with-an-uncommon-fracture
#11
Andrew H Schapiro, Neil U Lall, Christopher G Anton, Andrew T Trout
BACKGROUND: Self-balancing electric scooters, commonly known as hoverboards, are a new and popular consumer item with recognized fall hazards. The spectrum of injuries associated with hoverboard use has not been studied. OBJECTIVE: The purpose of this study is to determine the spectrum of radiologically apparent injuries associated with hoverboard use. MATERIALS AND METHODS: We retrospectively reviewed all imaging studies interpreted at our institution for hoverboard-related injuries during an 8-month period...
January 6, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28058483/three-dimensional-ultrasound-of-the-neonatal-brain-technical-approach-and-spectrum-of-disease
#12
Jessica Kurian, Susan Sotardi, Mark C Liszewski, William A Gomes, Thomas Hoffman, Benjamin H Taragin
Brain pathology is an important cause of morbidity and mortality in neonates, especially in the premature population. While conventional two-dimensional neurosonography is traditionally used for screening, diagnosis and monitoring of brain disorders such as germinal matrix hemorrhage, periventricular leukomalacia and hydrocephalus, three-dimensional ultrasonography has gained popularity in a variety of clinical applications in recent years. Three-dimensional ultrasonography is not yet widely utilized in pediatric imaging but is a potentially powerful tool for evaluating the neonatal brain...
January 5, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28050636/systematic-radiographic-evaluation-of-tibial-hemimelia-with-orthopedic-implications
#13
Katia Kaplan-List, Nina B Klionsky, James O Sanders, Michael E Katz
Tibial hemimelia is a rare lower-extremity pre-axial longitudinal deficiency characterized by complete or partial absence of the tibia. The reported incidence is 1 in 1 million live births. In this pictorial essay, we define tibial hemimelia and describe associated conditions and principles of preoperative imaging assessment for a child with tibial hemimelia. We also indicate the imaging findings that might influence the choice of treatment, describe the most widely used classification systems, and briefly discuss current treatment approaches...
January 3, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28035425/myocardial-stress-perfusion-magnetic-resonance-initial-experience-in-a-pediatric-and-young-adult-population-using-regadenoson
#14
Cory V Noel, Ramkumar Krishnamurthy, Brady Moffett, Rajesh Krishnamurthy
BACKGROUND: Dipyridamole and adenosine are traditional pharmacological stressors for myocardial perfusion. Regadenoson, a selective adenosine A2A agonist, has a lower side effect profile with lower incidence of bronchospasm and bradycardia. There is a growing need for myocardial perfusion assessment within pediatrics. There is no report on the utility of regadenoson as a stress agent in children. OBJECTIVE: To observe the safety and feasibility of regadenoson as a pharmacologic stressor for perfusion cardiac MR in a pilot cohort of pediatric patients weighing more than 40 kg who have congenital heart disease and pediatric acquired heart disease...
December 29, 2016: Pediatric Radiology
https://www.readbyqxmd.com/read/28004130/multifocal-bone-and-bone-marrow-lesions-in-children-mri-findings
#15
Maria Raissaki, Stelios Demetriou, Konstantinos Spanakis, Christos Skiadas, Nikolaos Katzilakis, Emmanouil G Velivassakis, Eftichia Stiakaki, Apostolos H Karantanas
Polyostotic bone and bone marrow lesions in children may be due to various disorders. Radiographically, lytic lesions may become apparent after loss of more than 50% of the bone mineral content. Scintigraphy requires osteoblastic activity and is not specific. MRI may significantly contribute to the correct diagnosis and management. Accurate interpretation of MRI examinations requires understanding of the normal conversion pattern of bone marrow in childhood and of the appearances of red marrow rests and hyperplasia...
December 21, 2016: Pediatric Radiology
https://www.readbyqxmd.com/read/27966039/magnetic-resonance-tissue-phase-mapping-demonstrates-altered-left-ventricular-diastolic-function-in-children-with-chronic-kidney-disease
#16
Charlotte Gimpel, Bernd A Jung, Sabine Jung, Johannes Brado, Daniel Schwendinger, Barbara Burkhardt, Martin Pohl, Katja E Odening, Julia Geiger, Raoul Arnold
BACKGROUND: Echocardiographic examinations have revealed functional cardiac abnormalities in children with chronic kidney disease. OBJECTIVE: To assess the feasibility of MRI tissue phase mapping in children and to assess regional left ventricular wall movements in children with chronic kidney disease. MATERIALS AND METHODS: Twenty pediatric patients with chronic kidney disease (before or after renal transplantation) and 12 healthy controls underwent tissue phase mapping (TPM) to quantify regional left ventricular function through myocardial long (Vz) and short-axis (Vr) velocities at all 3 levels of the left ventricle...
December 13, 2016: Pediatric Radiology
https://www.readbyqxmd.com/read/27957626/dynamic-contrast-enhanced-magnetic-resonance-imaging-of-the-wrist-in-children-with-juvenile-idiopathic-arthritis
#17
Charlotte M Nusman, Cristina Lavini, Robert Hemke, Matthan W A Caan, Dieneke Schonenberg-Meinema, Koert M Dolman, Marion A J van Rossum, J Merlijn van den Berg, Taco W Kuijpers, Mario Maas
BACKGROUND: Dynamic contrast-enhanced MRI provides information on the heterogeneity of the synovium, the primary target of disease in children with juvenile idiopathic arthritis (JIA). OBJECTIVE: To evaluate the feasibility of dynamic contrast-enhanced MRI in the wrist of children with JIA using conventional descriptive measures and time-intensity-curve shape analysis. To explore the association between enhancement characteristics and clinical disease status. MATERIALS AND METHODS: Thirty-two children with JIA and wrist involvement underwent dynamic contrast-enhanced MRI with movement-registration and were classified using validated criteria as clinically active (n = 27) or inactive (n = 5)...
December 12, 2016: Pediatric Radiology
https://www.readbyqxmd.com/read/27942776/percutaneous-guided-biopsy-for-diagnosing-suspected-primary-malignant-bone-tumors-in-pediatric-patients-a-safe-accurate-and-cost-saving-procedure
#18
Antony Ceraulo, Antoine Ouziel, Emilie Lavergne, Lionel Perrier, Anne-Valérie Decouvelaere, Franck Chotel, Philippe Thiesse, Perrine Marec-Berard
BACKGROUND: Percutaneous biopsy is the reference diagnostic procedure for adult musculoskeletal tumors. Its place in pediatrics is controversial and open biopsy remains recommended. OBJECTIVE: To assess diagnostic performance and feasibility of percutaneous biopsy performed on children and young adults for suspected malignant bone tumors. MATERIALS AND METHODS: We conducted a 5-year retrospective study including patients ≤21 years who underwent a bone biopsy for a suspected malignant bone tumor...
December 10, 2016: Pediatric Radiology
https://www.readbyqxmd.com/read/27933410/magnetic-resonance-imaging-patterns-of-treatment-related-toxicity-in-the-pediatric-brain-an-update-and-review-of-the-literature
#19
REVIEW
Maria Camilla Rossi Espagnet, Luca Pasquini, Antonio Napolitano, Antonella Cacchione, Angela Mastronuzzi, Roberta Caruso, Paolo Tomà, Daniela Longo
Treatment-related neurotoxicity is a potentially life-threatening clinical condition that can represent a diagnostic challenge. Differentiating diagnoses between therapy-associated brain injury and recurrent disease can be difficult, and the immediate recognition of neurotoxicity is crucial to providing correct therapeutic management, ensuring damage reversibility. For these purposes, the knowledge of clinical timing and specific treatment protocols is extremely important for interpreting MRI patterns. Neuroradiologic findings are heterogeneous and sometimes overlapping, representing the compounding effect of the different treatments...
December 9, 2016: Pediatric Radiology
https://www.readbyqxmd.com/read/27924361/prevalence-of-non-cardiovascular-findings-on-ct-angiography-in-children-with-congenital-heart-disease
#20
Archana Malik, Jeffrey C Hellinger, Sabah Servaes, Mathew C Schwartz, Marc S Keller, Monica Epelman
BACKGROUND: CT angiography is gaining broader acceptance in the evaluation of children with known or suspected congenital heart disease. These studies include non-cardiovascular structures such as the mediastinum, lung parenchyma and upper abdominal organs. It is important to inspect all these structures for potential abnormalities that might be clinically important and, in some cases, may impact care plans. OBJECTIVE: To determine the prevalence of non-cardiovascular findings in CT angiography of children with congenital heart disease...
December 6, 2016: Pediatric Radiology
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