Pediatric Radiology最新文献

{"title":"Structural and functional connectivity of the brain in premature infants with non-hemorrhagic punctate white matter lesions: a graph analysis.","authors":"Maria I Argyropoulou, Persefoni Margariti, Vasileios Xydis, Aikaterini Drougia, Effrosyni Styliara, Vasileios Giapros, Loukas G Astrakas","doi":"10.1007/s00247-025-06422-z","DOIUrl":"https://doi.org/10.1007/s00247-025-06422-z","url":null,"abstract":"<p><strong>Background: </strong>Abnormal diffusion tensor imaging (DTI) metrics have been reported both near and distant from non-hemorrhagic punctate white matter lesions, suggesting abnormal brain connectivity.</p><p><strong>Objective: </strong>To evaluate the effect of non-hemorrhagic punctate white matter lesions on both structural and functional brain connectivity in preterm infants.</p><p><strong>Materials and methods: </strong>DTI and resting-state functional magnetic resonance imaging (rs-fMRI) data acquired around term-equivalent age were analyzed using graph theory in nine preterm infants with non-hemorrhagic punctate white matter lesions (gestational age: mean±SD, 31.5 weeks±2.5 weeks) and nine gestational age-matched controls (mean, 31.4 weeks±2.5 weeks).</p><p><strong>Results: </strong>Both groups exhibited modularity, small-world topology, and rich-club organization. Compared with controls, infants with non-hemorrhagic punctate white matter lesions showed increased diffusion efficiency (0.0098±0.0003 vs. 0.0093±0.0003, P=0.03) in functional connectivity. In structural connectivity, the non-hemorrhagic punctate white matter lesions group demonstrated (a) increased betweenness centrality in the opercular part of the right inferior frontal gyrus (227.3±93.9 vs. 164.9±3.2, P<0.01); (b) increased characteristic path length in the left superior parietal lobe (48.7±3.1 vs. 46.9±3.1, P<0.01), left inferior parietal lobe (53.0±3.3 vs. 50.8±3.5, P<0.01), and right angular gyrus (61.1±4.3 vs. 55.8±4.3, P<0.01); and (c) increased participation coefficient in the inferior temporal gyrus (0.14±0.20 vs. 0.03±0.09, P<0.01).</p><p><strong>Conclusions: </strong>In preterm infants, non-hemorrhagic punctate white matter lesions appear to disrupt modularity in functional networks and structural connectivity in the dorsal visual stream, with compensatory changes in the ventral stream. They are also associated with increased structural connectivity in regions linked to risk aversion.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetic resonance imaging-based assessment of hippocampal glutamate and morphometric changes in preterm infants at term-equivalent age with low birth weight.","authors":"Lumeng Xu, He Gong, Qingfa Ren, Shuyuan Xia, Minglong Li, Hongyu Ning, Quanyuan Liu, Caixia Yang, Jing Wang, Zhijie Yin, Xianglin Li","doi":"10.1007/s00247-025-06435-8","DOIUrl":"https://doi.org/10.1007/s00247-025-06435-8","url":null,"abstract":"<p><strong>Background: </strong>Low birth weight and preterm infants may have higher risks of poor health. As the key brain region for learning and memory, normal development of the hippocampus is crucial for the cognitive abilities of preterm infants.</p><p><strong>Objective: </strong>This study aimed to analyze hippocampal glutamate (Glu) levels and morphometric changes in preterm infants at term-equivalent age (TEA) with different birth weights.</p><p><strong>Materials and methods: </strong>Eighty-seven infants (23 full-term infants and 64 preterm infants) born between 2023 and 2025, underwent magnetic resonance imaging (MRI) at TEA. Glutamate chemical exchange saturation transfer (GluCEST) MRI and 3D-SPACE were used to assess hippocampal Glu levels and morphometric changes. The preterm cohort was categorized by birth weight: preterm infants born at extremely and very low birth weight (Group 1), preterm infants born at low birth weight (Group 2) and preterm infants born at normal birth weight (Group 3). Full-term infants born at normal birth weight (Group 4) were included as controls.</p><p><strong>Results: </strong>Group 1 exhibited elevated Glu levels, Group 2 showed intermediate Glu levels. In infants with normal birth weight, preterm at TEA have higher glutamate levels than full-term infants. No differences were observed in the bilateral hippocampal Glu levels within each group. The bilateral hippocampal volume, surface area, and long diameter in Group 1 were all significantly smaller than those in Group 3. Morphological analysis revealed rightward hippocampal asymmetry in all preterm groups.</p><p><strong>Conclusion: </strong>Birth weight significantly influences hippocampal glutamate levels and morphology in preterm infants. These findings offer new insights into the metabolic variations in preterm neurodevelopment.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145346543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-pool chemical exchange saturation transfer magnetic resonance imaging as a molecular-specific biomarker: detecting histopathological changes in neonatal hypoxic-ischemic encephalopathy.","authors":"Xiamei Zhuang, Yupeng Wu, Guihua Jiang, Ke Jin, Jianqi Li, Junwei Li, Meitao Liu, Yanfang Wu, Huiting Zhang, Huashan Lin","doi":"10.1007/s00247-025-06417-w","DOIUrl":"https://doi.org/10.1007/s00247-025-06417-w","url":null,"abstract":"<p><strong>Background: </strong>Neonatal hypoxic-ischemic encephalopathy (HIE) diagnosis is confounded by heterogeneous neural injury and metabolic dysfunction. Multi-pool chemical exchange saturation transfer (CEST) magnetic resonance imaging (MRI) uniquely quantifies amide proton transfer, nuclear Overhauser enhancement, and magnetization transfer signals, providing multi-parametric assessment of HIE pathophysiology.</p><p><strong>Objective: </strong>To investigate whether multi-pool CEST MRI can serve as a molecular-specific biomarker for histopathological alterations in HIE and assess its efficacy in grading disease severity.</p><p><strong>Materials and methods: </strong>This prospective study included 20 neonates with HIE and 42 age-matched controls undergoing 3.0-T CEST MRI. Imaging data were spatially normalized to a neonatal atlas for region-specific analysis (caudate, putamen, thalamus, pallidum, amygdala, hippocampus). Group differences in CEST signals (amide proton transfer, nuclear Overhauser enhancement, magnetization transfer) were analyzed via Wilcoxon tests, with diagnostic performance evaluated through receiver operating characteristic analysis.</p><p><strong>Results: </strong>Compared to controls, HIE neonates showed significant reductions in amide proton transfer (bilateral putamen, right hippocampus/pallidum/amygdala, left thalamus/caudate), nuclear Overhauser enhancement (left thalamus/caudate/putamen), and magnetization transfer signals (bilateral thalamus/pallidum/putamen, left caudate; all P<0.05). Subgroup analysis revealed progressive metabolic decline: moderate-to-severe HIE exhibited further amide proton transfer reduction in the right thalamus, nuclear Overhauser enhancement decreases in bilateral hippocampus, and magnetization transfer decreases in left hippocampus/thalamus compared to mild cases (all P<0.05). Notably, conventional amide proton transfer-weighted imaging showed no significant changes, as the reduction in amide proton transfer signal was offset by a concurrent decrease in the nuclear Overhauser enhancement, highlighting the superiority of multi-pool analysis. Left hippocampal nuclear Overhauser enhancement demonstrated exceptional severity discrimination (area under curve (AUC)=0.96), while a multi-region integrated model achieved perfect staging accuracy (AUC=1.00).</p><p><strong>Conclusion: </strong>Multi-pool CEST MRI effectively captures histopathological changes in neonatal HIE, with left hippocampal nuclear Overhauser enhancement emerging as a precise biomarker for severity stratification. The combined dynamics of amide proton transfer, nuclear Overhauser enhancement, and magnetization transfer signals provide noninvasive insights into metabolic-pathological correlations, highlighting its transformative potential for early diagnosis and targeted therapeutic monitoring.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145346471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fetal cardiac masses.","authors":"Bhagyashree Rathore, Marissa E Adamson, Lara E Berklite, Pradipta Debnath, Beth M Kline-Fath, Kimberley G Miles, Cara E Morin, Kristin A Schneider","doi":"10.1007/s00247-025-06431-y","DOIUrl":"https://doi.org/10.1007/s00247-025-06431-y","url":null,"abstract":"<p><p>Although rare in the pediatric population, cardiac tumors represent a significant portion of prenatally detected masses, second only to sacrococcygeal teratomas. Fetal cardiac masses are predominantly benign, with rhabdomyoma being the most common fetal cardiac mass in the setting of tuberous sclerosis. Multiple lesions are pathognomonic for rhabdomyomas and prompt evaluation for tuberous sclerosis. Fibroma, teratoma, and hemangioma are other consistently detected cardiac tumors. In this article, we review the epidemiology, imaging, treatment, and outcomes of these fetal cardiac masses, emphasizing the role of imaging in surveillance, identifying complications, refining the differential diagnosis, and recognizing potential diagnostic pitfalls.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145346458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cholelithiasis in the accessory gallbladder of an accessory liver.","authors":"Dilek Sağlam, Zeynep Yazıcı","doi":"10.1007/s00247-025-06440-x","DOIUrl":"https://doi.org/10.1007/s00247-025-06440-x","url":null,"abstract":"<p><p>We report a case of a 16-year-old girl with cholelithiasis in the accessory gallbladder of an accessory liver. A parenchymal cyst was also present in the accessory liver. The accessory lobe of the liver is a rare congenital anomaly with supernumerary liver lobes caused by hyperplasia of the hepatic diverticulum in early fetal life. The presence of an accessory gallbladder is scarce. To our knowledge, this case is the first reported with cholelithiasis in the only gallbladder of the patient located in the accessory liver. This case reiterates the importance of familiarity of radiologists with this congenital anomaly, accessory liver and gallbladder, which may also lead to complications.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The gorilla lip sign: diagnostic utility of anteroposterior radiographs for pediatric talocalcaneal coalition.","authors":"Yueqiang Mo, Haodong Li, Peng Huang, Yanhui Jing, Bo Ning, Yuerong Zhang, Dahui Wang","doi":"10.1007/s00247-025-06430-z","DOIUrl":"https://doi.org/10.1007/s00247-025-06430-z","url":null,"abstract":"<p><strong>Background: </strong>Talocalcaneal coalition is highly prevalent but diagnostically challenging due to the subtalar joint's complex anatomy, leading to frequent oversights on conventional radiographs. Existing signs rely primarily on lateral views, with variable sensitivity.</p><p><strong>Objective: </strong>To introduce and validate the \"gorilla lip\" sign on non-weight-bearing anteroposterior (AP) radiographs as a complementary diagnostic marker for talocalcaneal coalition.</p><p><strong>Materials and methods: </strong>In this retrospective study, non-weight-bearing AP ankle radiographs of 30 talocalcaneal coalition-confirmed feet (positive group) and 33 normal feet (negative group) from children aged ≤17 years were analyzed. The \"gorilla lip\" sign was defined by sustentaculum tali abnormalities: (1) osseous protuberance ≥50% medial malleolus height, (2) narrowed and rough articular surface, or (3) absent joint space. Three blinded observers independently assessed randomized images twice (2-month interval). Sensitivity, specificity, likelihood ratios, and inter-/intraobserver reliability were calculated.</p><p><strong>Results: </strong>Across two evaluations by three observers, sensitivity ranged from 77-93%, and specificity ranged from 85-100%. Positive likelihood ratios were ranging from 5.28 to infinite, indicating a high probability of talocalcaneal coalition when the sign is present, while low negative likelihood ratios (ranging from 0.07 to 0.24) suggest its absence is a strong indicator to rule out talocalcaneal coalition. The sign showed good interobserver reliability (Fleiss kappa, 0.65-0.70) and good to excellent intraobserver reliability (kappa, 0.67-0.87).</p><p><strong>Conclusions: </strong>The \"gorilla lip\" sign is a highly sensitive, specific, and reproducible radiographic marker for diagnosing talocalcaneal coalition on non-weight-bearing AP ankle radiographs. Its application can complement traditional lateral view signs, enhancing diagnostic confidence and potentially reducing unnecessary examinations prompted by misdiagnosis.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retroaortic retrocaval reverse horseshoe kidney associated with vertebral and spinal cord anomalies.","authors":"Demamu Agegn, Biniyam Beyene Tabor, Ashenafi A Buser, Alemayehu Bedane Worke, Bethelhem Belachew","doi":"10.1007/s00247-025-06399-9","DOIUrl":"https://doi.org/10.1007/s00247-025-06399-9","url":null,"abstract":"<p><p>While horseshoe kidneys are the most common renal fusion anomaly, various complex variant anatomies exist. One rare form is the retroaortic retrocaval reverse horseshoe kidney, where the upper poles fuse posterior to both the aorta and inferior vena cava. These intricate renal anomalies increase complication risk and complicate surgical interventions. We report a 3-year-old boy diagnosed with a retroaortic retrocaval reverse horseshoe kidney during a spinal deformity evaluation. This case is one of few instances of this specific variant documented in the literature and is the first to be associated with type 1 diastematomyelia and tethered cord.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Segmental spinal dysgenesis - a rare type of spinal dysraphism.","authors":"Neha Singhal, Nishat Amina, Ravi Shankar Solanki","doi":"10.1007/s00247-025-06427-8","DOIUrl":"https://doi.org/10.1007/s00247-025-06427-8","url":null,"abstract":"<p><p>Segmental spinal dysgenesis is a rare and complex congenital anomaly that affects the spinal cord. It is hypothesized to be a notochord malformation. Patients generally present with spastic paraparesis and a neurogenic bladder. It is characterized by focal spinal cord dysgenesis and kyphoscoliotic deformity. We present the case of a 2-year-old boy who presented to the outpatient department of our hospital with complaints of recurrent urinary tract infection and fever. On examination, he had bilateral clubfoot, kyphoscoliotic deformity, and paraparesis. Further examination by micturating cystourethrogram revealed bilateral grade V vesico-ureteric reflux. Cystoscopy ruled out a posterior urethral valve. Magnetic resonance imaging of the spine was conducted to evaluate any neurological cause, which revealed a high blunt ending of the spinal cord at the dorsal level 10, with the absence of spinal cord tissue between dorsal 10 and sacral 2 level. Bulky cord-like tissue was noted from the sacral 2-4 level. These findings were associated with a syrinx formation and multiple vertebral malformations. The patient was managed conservatively.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumoral calcinosis with epiphyseal involvement in the knee.","authors":"Tingting Zhao, Xianghong Meng, Zhi Wang","doi":"10.1007/s00247-025-06418-9","DOIUrl":"https://doi.org/10.1007/s00247-025-06418-9","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145329668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary: How to incorporate bowel ultrasound as a part of the routine care of neonates with necrotizing enterocolitis.","authors":"Catalina Le Cacheux, Sherwin S Chan","doi":"10.1007/s00247-025-06429-6","DOIUrl":"https://doi.org/10.1007/s00247-025-06429-6","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145302385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}