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Pediatric fluoroscopy

Ahmad S Azhar
OBJECTIVES: To assess the safety and effectiveness of transthoracic echocardiography (TTE) in monitoring transcatheter closure of atrial septal defect (ASD), in comparison with conventional technique using transesophageal echocardiography (TEE).  Methods: A retrospective review of all cases of transcatheter closure of isolated ostium secundum ASDs operated from 2005 to 2015, at the Pediatric Interventional Cardiology Department, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia...
November 2016: Saudi Medical Journal
Michael J Callahan, Jennifer M Talmadge, Robert D MacDougall, Patricia L Kleinman, George A Taylor, Carlo Buonomo
In our experience, questions about the appropriate use of enteric contrast media for pediatric fluoroscopic studies are common. The purpose of this article is to provide a comprehensive review of enteric contrast media used for pediatric fluoroscopy, highlighting the routine use of these media at a large tertiary care pediatric teaching hospital.
October 10, 2016: Pediatric Radiology
Bobby Wirawan Hassan, Bong Ju Moon, Young-Jin Kim, Sang-Deok Kim, Ki-Young Choi, Jung-Kil Lee
INTRODUCTION: Langerhans cell histiocytosis (LCH) occurs rarely in the spine of adults. The radiological findings usually resemble vertebral tumors. Etiology of LCH has not been clearly established yet. Therapeutic approaches are still controversial. We describe a case of LCH in an adult spine. CASE DESCRIPTION: A patient who presented with low back pain had an osteolytic lesion in the L1 vertebral body without neurological deficits, and fluoroscopy-guided needle biopsy of the L1 vertebral body was performed...
2016: SpringerPlus
Ersin Erçin, Mustafa Gökhan Bilgili, Emre Baca, Serdar Hakan Başaran, Alkan Bayrak, Cemal Kural, Mustafa Cevdet Avkan
BACKGROUND: The present objective was to compare medial mini-open and percutaneous treatment of pediatric supracondylar fractures according to fluoroscopy time, duration of surgery, and iatrogenic ulnar nerve injury. METHODS: A total of 104 Gartland type III supracondylar humerus fractures were prospectively evaluated between 2011 and 2013. Patients were divided into 2 groups according to type of fixation. In Group A (41 patients), medial pin was inserted with mini-open incision with 2 lateral pins inserted percutaneously...
July 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Theodore B Gupton, Jorge Delgado, Diego Jaramillo, Anne M Cahill, Nancy A Chauvin
BACKGROUND: There is no consensus in the literature concerning the optimal approach for performing a fluoroscopically guided shoulder arthrogram injection in a pediatric population. OBJECTIVE: To compare adequacy of capsular injection and radiation doses between fluoroscopically guided anterior and posterior glenohumeral joint contrast injections in adolescents. MATERIALS AND METHODS: We evaluated imaging in 67 adolescents (39 boys, 28 girls; mean age 16...
September 1, 2016: Pediatric Radiology
Harmen Bijwaard, Doreth Valk, Ischa de Waard-Schalkx
A survey about radiation protection in pediatric radiology was conducted among 22 general and seven children's hospitals in the Netherlands. Questions concerned, for example, child protocols used for CT, fluoroscopy and x-ray imaging, number of images and scans made, radiation doses and measures taken to reduce these, special tools used for children, and quality assurance issues. The answers received from 27 hospitals indicate that radiation protection practices differ considerably between general and children's hospitals but also between the respective general and children's hospitals...
October 2016: Health Physics
Ellen C Benya, Mary R Wyers, Ellen K O'Brien
BACKGROUND: Life-threatening midgut volvulus usually occurs in infants with malrotation and requires rapid diagnosis and surgical treatment to prevent bowel necrosis and death. However, because of the low frequency of upper gastrointestinal studies performed in infants younger than 1 month, many diagnostic radiology residents finish their residency training having limited or no opportunity to perform or observe an upper gastrointestinal (GI) series for evaluation of bilious emesis in a neonate...
August 25, 2016: Pediatric Radiology
Moritz Wildgruber, René Müller-Wille, Holger Goessmann, Wibke Uller, Walter A Wohlgemuth
OBJECTIVE: The aim of the study was to calculate the effective dose during fluoroscopy-guided pediatric interventional procedures of the liver in a phantom model before and after adjustment of preset parameters. METHODS: Organ doses were measured in three anthropomorphic Rando-Alderson phantoms representing children at various age and body weight (newborn 3.5kg, toddler 10kg, child 19kg). Collimation was performed focusing on the upper abdomen representing mock interventional radiology procedures such as percutaneous transhepatic cholangiography and drainage placement (PTCD)...
2016: PloS One
Nada A Ahmed, A I Nayel
Children are more radio sensitive than adult. This study aims to assess radiation doses and the associated hazards to pediatric during cardiac catheterization procedures. Radiation dose for 112 patients was estimated in the biggest cardiac center in Sudan. The median KAP in Gy cm(2), CK in mGy, number of frames and fluoroscopy time in minutes were (4.6, 29.0, 340.4, 13.5) and (6.0, 35.0, 318, 9.8) for the diagnostic and therapeutic cardiac procedures, respectively. The median (KAP in Gy cm(2), effective dose in mSv) for different age groups in the intervals of less than 1 year, 1-<5 years, 5-<10 years and 10-15 years old were (2...
August 13, 2016: Radiation Protection Dosimetry
Julie A Neumann, Sandeep Mannava, Christopher E Gross, Benjamin M Wooster, Michael T Busch
Symptomatic subfibular and/or lateral talocalcaneal impingement in pediatric patients may result from an accessory anterolateral talar facet (AALTF). This impingement may cause pain and disability and may limit athletic performance in high-level athletes. We report the case of a 12-year-old female competitive gymnast who had refractory, lateral-sided right ankle pain for 4 months and underwent right ankle arthroscopic resection of the AALTF causing impingement. Standard medial and anterolateral portals with the addition of an accessory anterolateral-distal portal were used in conjunction with a 30° 2...
April 2016: Arthroscopy Techniques
Eva Corredoira, Eliseo Vañó, Luis Alejo, Carlos Ubeda, Federico Gutiérrez-Larraya, Julia Garayoa
The aim of this study was to assess image quality and radiation dose of a biplane angiographic system with cone-beam CT (CBCT) capability tuned for pediatric cardiac procedures. The results of this study can be used to explore dose reduction techniques. For pulsed fluoroscopy and cine modes, polymethyl methacrylate phantoms of various thicknesses and a Leeds TOR 18-FG test object were employed. Various fields of view (FOV) were selected. For CBCT, the study employed head and body dose phantoms, Catphan 504, and an anthropomorphic cardiology phantom...
2016: Journal of Applied Clinical Medical Physics
Alvin W Su, Amy L McIntosh, Beth A Schueler, Todd A Milbrandt, Jennifer A Winkler, Anthony A Stans, A Noelle Larson
BACKGROUND: Intraoperative C-arm fluoroscopy and low-dose O-arm are both reasonable means to assist in screw placement for idiopathic scoliosis surgery. Both using pediatric low-dose O-arm settings and minimizing the number of radiographs during C-arm fluoroscopy guidance decrease patient radiation exposure and its deleterious biological effect that may be associated with cancer risk. We hypothesized that the radiation dose for C-arm-guided fluoroscopy is no less than low-dose O-arm scanning for placement of pedicle screws...
August 1, 2015: Journal of Pediatric Orthopedics
Hoang H Nguyen, David T Balzer, Joshua J Murphy, Ramzi Nicolas, Shabana Shahanavaz
This retrospective study aims to evaluate radiation exposure by three-dimensional rotational angiography (3DRA) during trans-catheter Melody pulmonary valve (TMPV) procedures. 3DRA has been reported to have added value in the management of complex congenital heart disease aiding in the performance of interventional procedures albeit with concerns of higher radiation exposure. We test the hypothesis that 3DRA does not cause additional radiation exposure during TMPV procedures. We analyzed all 81 TMPV procedures performed at St...
July 25, 2016: Pediatric Cardiology
David M Kwartowitz, Fuad N Mefleh, G Hamilton Baker
PURPOSE: Radiation exposure in interventional cardiology is an important consideration, due to risk of cancer and other morbidity to the patient and clinical staff. Cardiac catheterizations rely heavily on fluoroscopic imaging exposing both patient and clinician to ionizing radiation. An image-guided surgery system capable of facilitating cardiac catheterizations was developed and tested to evaluate dose reduction. METHODS: Several electromagnetically tracked tools were constructed specifically a 7-Fr catheter with five 5-degree-of-freedom magnetic seeds...
July 19, 2016: International Journal of Computer Assisted Radiology and Surgery
Edward J Richer, Ramon Sanchez
BACKGROUND/PURPOSE: Spontaneous pneumomediastinum is an infrequent condition in pediatric patients. Presenting symptoms include chest pain, dysphagia, or vomiting, without initiating event. Patients may undergo esophagram because of concern for esophageal perforation as the source for pneumomediastinum, however, abnormalities are rarely demonstrated. The objective of this study is to identify whether esophagrams performed on pediatric patients for spontaneous pneumomediastinum are warranted...
June 6, 2016: Journal of Pediatric Surgery
Jeffrey E Martus, Melissa A Hilmes, Jared V Grice, Christopher M Stutz, Jonathan G Schoenecker, Steven A Lovejoy, Gregory A Mencio
BACKGROUND: Factors that impact radiation exposure during operative fixation of pediatric supracondylar humerus (SCH) fractures have been investigated; however, no studies have measured the equivalent dose at the patient's radiosensitive organs. Our hypothesis was that intraoperative fluoroscopy exposes pediatric patients to a significant radiation load and lead shielding of radiosensitive organs is important. The goal of the study was to quantify the patient's radiation exposure during the procedure by measuring the radiation load at the thyroid and gonads...
June 8, 2016: Journal of Pediatric Orthopedics
Kimberly I Mills, Julie A Vincent, Warren A Zuckerman, Timothy M Hoffman, Charles E Canter, Audrey C Marshall, Elizabeth D Blume, Lisa Bergersen, Kevin P Daly
Endomyocardial biopsy (EMB) is a common procedure used to aid in the diagnosis, prognosis and treatment of suspected pediatric cardiomyopathy. In suspected cardiomyopathy, no multicenter experience has previously reported on the safety and utility of EMBs. Retrospectively, adverse event (AE) and patient and procedural characteristics were obtained at seven institutions participating in the Congenital Cardiac Catheterization Outcomes Project for both a cardiomyopathy (n = 158) and a post-transplant surveillance (n = 2665) cohort...
October 2016: Pediatric Cardiology
John A Scolaro, Reza Firoozabadi, Milton L Chip Routt
BACKGROUND: Pediatric and adolescent pelvic ring injuries are frequently treated without surgery. In patients with unstable injuries to the pelvic ring, surgical stabilization aids in resuscitation, provides pain relief, and allows for mobilization. Percutaneous pelvic screw fixation is commonly performed in adult patients for unstable pelvic ring injuries, but a paucity of literature exists regarding their use in pediatric patients. The purpose of this study is to review the use, outcome, and management of percutaneous posterior pelvic screws in pediatric patients with unstable pelvic ring injuries...
June 2, 2016: Journal of Pediatric Orthopedics
Michael E Chua, Jessica M Ming, Walid A Farhat
Diagnostic imaging in pediatric urology has traditionally relied upon multiple modalities based on availability, use of ionizing radiation, and invasiveness to evaluate urological anomalies. These modalities include ultrasonography, voiding cystourethrography, fluoroscopy and radionuclide scintigraphy. Magnetic resonance urography (MRU) has become increasingly useful in depicting more detailed abdominal and pelvic anatomy, specifically in duplex collecting systems, ectopic ureter, ureteropelvic junction (UPJ) obstruction, megaureter and congenital pelvic anomalies...
May 2016: Pediatric Radiology
Michael L O'Byrne, Matthew J Gillespie, Kevin F Kennedy, Yoav Dori, Jonathan J Rome, Andrew C Glatz
BACKGROUND: Concern regarding aortic erosion has focused attention on the retro-aortic rim in patients undergoing device closure of atrial septal defects (ASD), but its effect on early outcomes is not well studied. METHODS: A multicenter retrospective cohort study of patients undergoing device occlusion of ASD between 1/2011-10/2014 was performed, using data from the IMproving Pediatric and Adult Congenital Treatment Registry. Subjects were divided between those with retro-aortic rim <5 and ≥5 mm...
May 18, 2016: Catheterization and Cardiovascular Interventions
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