Pediatric Radiology最新文献

{"title":"Direct percutaneous access of the thoracic duct in a neonate as curative treatment of a high-output life-threatening chylothorax due to thrombotic occlusion of the thoracic duct-venous junction.","authors":"Daniel Kronenberg, Hitendu Dave, Oliver Kretschmar, Alessandra Bosch, Janet Kelly-Geyer, Christian Johannes Kellenberger, Ralph Gnannt","doi":"10.1007/s00247-025-06412-1","DOIUrl":"https://doi.org/10.1007/s00247-025-06412-1","url":null,"abstract":"<p><p>A life-threatening chylothorax developed in a female neonate after corrective surgery of d-transposition of the great arteries complicated by extensive postoperative thrombosis of the superior vena cava distribution, including at the thoracic duct-venous junction. Emergent percutaneous catheter intervention for thrombus aspiration and transluminal angioplasty was required. Despite therapeutic heparinization, thrombosis persisted. Curative image-guided treatment was twofold: first, the occluded thoracic duct was punctured under ultrasound guidance; then, the thrombus at the thoracic duct-venous junction was mobilized using the Seldinger-technique. Additionally, a venous catheter was placed with the tip at the thoracic duct-venous junction, and local low-dose thrombolysis was administered. This case shows that it is possible to percutaneously access the thoracic duct by direct puncture in a neonate with ultrasound guidance.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207300","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":"Can metaphyseal variations in the distal femurs and proximal tibias be distinguished from classic metaphyseal lesions?","authors":"Boaz Karmazyn, Christopher L Newman, Megan B Marine, Matthew R Wanner, Jared R Shields, Lisa R Delaney, Scott D Steenburg, Alexander G Boutselis, Jordan H Cuskaden, Eric D Westin, Marrisa J Luoma, S Gregory Jennings, George J Eckert, Ralph A Hicks","doi":"10.1007/s00247-025-06398-w","DOIUrl":"https://doi.org/10.1007/s00247-025-06398-w","url":null,"abstract":"<p><strong>Background: </strong>Classic metaphyseal lesions (CMLs) are considered specific for child abuse, but the reliability of radiologists in distinguishing CMLs from metaphyseal variations is unclear.</p><p><strong>Objective: </strong>To evaluate the diagnostic performance of pediatric and adult emergency radiologists in differentiating CMLs from metaphyseal variations in the knees.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed distal femur and proximal tibia radiographs in children under 1 year of age who underwent skeletal surveys for suspected child abuse. A consensus diagnosis for CMLs and metaphyseal variations-serving as the ground truth-was established by two pediatric radiologists. The CML group comprised children diagnosed with abuse and confirmed CMLs. The metaphyseal variation group included children not diagnosed with abuse, who exhibited metaphyseal variations and had either no fractures or only an isolated skull fracture. Radiographs were trimmed to exclude other injuries. Four pediatric and four adult radiologists reviewed anonymized studies and categorized each case as CML, metaphyseal variation, normal, or indeterminate, with confidence levels (high, moderate, low). We analyzed diagnoses with moderate or high confidence. Interobserver agreement was assessed using kappa statistics.</p><p><strong>Results: </strong>There were 44 children with CMLs (10 initial, 7 follow-up, 27 initial and follow-up) and 22 with metaphyseal variations (10 initial, 7 follow-up, 5 initial and follow-up). Metaphyseal fragmentation was the most common variation, identified in 249 of 344 femurs (72.4%, 95% CI 67.3-77.0%) and 60 of 69 tibias (87.0%, 76.7-93.9%). Fragmentations were most frequently located in the posterior or medial metaphysis, or both, in 238 of 249 femurs (95.6%, 92.2-97.8%) and 60 of 69 tibias (87.0%, 76.7-93.9%). In the CML group, 33 of 114 initial CML diagnoses (28.9%, 20.8-38.2%) were read on follow-up as either metaphyseal variation (n = 17) or normal (n = 16). In contrast, in the metaphyseal variation group, only one follow-up case was diagnosed as a CML; the remainder were diagnosed on follow-up as metaphyseal variation (n = 24). Diagnostic performance for CML demonstrated high specificity (90.9%, 85.6-94.7%) and positive predictive value (95.6%, 93.0-97.5%), with moderate accuracy (79.3%, 75.9-82.4%), sensitivity (74.9%, 70.8-78.8%), and negative predictive value (57.6%, 51.5-63.5%). Interobserver agreement was substantial, with a mean kappa of 0.61 (range 0.45-0.84).</p><p><strong>Conclusion: </strong>Radiologists demonstrated substantial agreement and high specificity in distinguishing CMLs from metaphyseal variations. Metaphyseal fragmentation was the most common variation and was uncommonly diagnosed as CML on follow-up.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200319","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":"A step-by-step guide for cardiac computed tomography ventricular volumetry using three-dimensional threshold-based segmentation for congenital heart disease.","authors":"Hyun Woo Goo, Haifa Abdul Latiff","doi":"10.1007/s00247-025-06409-w","DOIUrl":"https://doi.org/10.1007/s00247-025-06409-w","url":null,"abstract":"<p><p>In addition to morphologic evaluation, cardiac computed tomography with a short scan time and a high spatial resolution may be performed to assess ventricular function in children with congenital heart disease, especially when cardiac magnetic resonance imaging is unavailable, inadequate, or contraindicated. Caution should be exercised over the computed tomography radiation dose because greater radiation doses are used to assess ventricular function than morphology. The three-dimensional threshold-based segmentation approach leads to higher accuracy and reproducibility of ventricular volumetry than the conventional approach, which frequently uses simplified contouring and two-dimensional disc summation. However, this approach is less frequently utilized in clinical practice than the conventional approach. Therefore, a step-by-step guide to cardiac computed tomography ventricular volumetry using three-dimensional threshold-based segmentation is presented for congenital heart disease.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200195","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":"Ultrasound radiomics for identifying microstructural changes in the femoral head with developmental dysplasia of the hip.","authors":"Jiawei Hao, Xingyue Wang, Zheng Pan, Meng Zuo, Yongmei Jia, Yang Lv, Yu Wang, Xiaodong Liu","doi":"10.1007/s00247-025-06358-4","DOIUrl":"https://doi.org/10.1007/s00247-025-06358-4","url":null,"abstract":"<p><strong>Background: </strong>Non-invasive imaging methods for evaluating microstructural changes in patients with developmental dysplasia of the hip (DDH) are lacking.</p><p><strong>Objective: </strong>To explore the feasibility of hip ultrasound radiomics to evaluate microstructural changes of the femoral head in patients with DDH.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted on 59 patients with DDH and 66 healthy controls who underwent hip ultrasound examination. We used three-dimensional (3D) Slicer software to obtain femoral head ultrasound radiomics features and compared them between the DDH and healthy control groups. A predictive model was established by using the maximum relevance minimum redundancy (mRMR) and least absolute shrinkage and selection operator (LASSO) methods. The receiver operating characteristic (ROC) curve was used to determine the performance of the model.</p><p><strong>Results: </strong>There were significant differences (P < 0.05) in 69 ultrasound radiomics features of the femoral head between the patients with DDH and healthy controls. By using mRMR, 12 features were selected for further analysis via LASSO. We have successfully established a predictive model based on nine features. The area under the curve (AUC) of the model was 0.91 for the validation set.</p><p><strong>Conclusion: </strong>We developed a predictive model based on ultrasound radiomics, and the model had good differential diagnostic efficacy in patients with DDH and healthy individuals.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200282","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":"Lung nodules in pediatric osteosarcoma: calcification as the most reliable radiological indicator to confirm metastasis.","authors":"Helena Martínez Sánchez, Adela Cañete Nieto, Daniel Sánchez Mateos, Nuria Benavent, Josep Escrivá Fernández, Andrea Sánchez Robles, Carmela Paula Galley Martín, Jesús García Vázquez, Marta Salom Taverner, Alfredo Marco Macián, Antonio Juan Ribelles","doi":"10.1007/s00247-025-06410-3","DOIUrl":"https://doi.org/10.1007/s00247-025-06410-3","url":null,"abstract":"<p><strong>Background: </strong>Osteosarcoma is the most common bone pediatric cancer, with the lung being the primary site of metastasis. A chest computed tomography scan (CT) is used to assess metastatic disease at diagnosis, classifying patients as localized or metastatic. Although there are radiological characteristics that suggest whether a lung nodule is metastatic, in daily practice, non-specific lesions on CT may complicate classification.</p><p><strong>Objective: </strong>Our objective is to compare radiological findings with the histology of lung nodules deemed malignant by CT and to review current radiological criteria.</p><p><strong>Materials and methods: </strong>A retrospective review was conducted of lung nodules in patients under 18 years old, diagnosed with osteosarcoma between 2014-2024 in a tertiary hospital. Radiological features, including calcification, size, shape, and location, were analyzed for their correlation with histological confirmation of metastasis.</p><p><strong>Results: </strong>In 33 osteosarcoma patients, 116 nodules were identified as malignant by radiology. A total of 69% of patients had pulmonary nodules that met radiological criteria for malignancy during follow-up. All underwent surgical resection. Histology confirmed metastasis in 49% (57/116) of the nodules that were suspicious on CT. Only calcification showed a significant correlation with histological confirmation of metastasis.</p><p><strong>Conclusions: </strong>CT imaging has an optimal sensitivity but low specificity for detecting lung metastases in osteosarcoma. However, we demonstrate that calcification is significantly correlated with histological confirmation of metastasis and may aid in confirming lung metastasis in osteosarcoma patients. Still, further studies are needed to refine radiological criteria to improve accuracy and reduce false positive rates.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186440","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":"Correction: Diagnostic performance and reproducibility of shear wave elastography techniques for liver stiffness assessment in children with biliary atresia.","authors":"Manli Fu, Chao Geng, Liqiong Shi, Jiaoyan Tan, Han Jing, Xueqiang Yan, Li Yuan","doi":"10.1007/s00247-025-06407-y","DOIUrl":"https://doi.org/10.1007/s00247-025-06407-y","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145177121","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":"Proof-of-concept comparison of an artificial intelligence-based bone age assessment tool with Greulich-Pyle and Tanner-Whitehouse version 2 methods in a pediatric cohort.","authors":"Luca Marinelli, Antonio Lo Mastro, Francesca Grassi, Daniela Berritto, Anna Russo, Vittorio Patanè, Anna Festa, Enrico Grassi, Anna Grandone, Luigi Aurelio Nasto, Enrico Pola, Alfonso Reginelli","doi":"10.1007/s00247-025-06405-0","DOIUrl":"https://doi.org/10.1007/s00247-025-06405-0","url":null,"abstract":"<p><strong>Background: </strong>Bone age assessment is essential in evaluating pediatric growth disorders. Artificial intelligence (AI) systems offer potential improvements in accuracy and reproducibility compared to traditional methods.</p><p><strong>Objective: </strong>To compare the performance of a commercially available artificial intelligence-based software (BoneView BoneAge, Gleamer, Paris, France) against two human-assessed methods-the Greulich-Pyle (GP) atlas and Tanner-Whitehouse version 2 (TW2)-in a pediatric population.</p><p><strong>Materials and methods: </strong>This proof-of-concept study included 203 pediatric patients (mean age, 9.0 years; range, 2.0-17.0 years) who underwent hand and wrist radiographs for suspected endocrine or growth-related conditions. After excluding technically inadequate images, 157 cases were analyzed using AI and GP-assessed methods. A subset of 35 patients was also evaluated using the TW2 method by a pediatric endocrinologist. Performance was measured using mean absolute error (MAE), root mean square error (RMSE), bias, and Pearson's correlation coefficient, using chronological age as reference.</p><p><strong>Results: </strong>The AI model achieved a MAE of 1.38 years, comparable to the radiologist's GP-based estimate (MAE, 1.30 years), and superior to TW2 (MAE, 2.86 years). RMSE values were 1.75 years, 1.80 years, and 3.88 years, respectively. AI showed minimal bias (-0.05 years), while TW2-based assessments systematically underestimated bone age (bias, -2.63 years). Strong correlations with chronological age were observed for AI (r=0.857) and GP (r=0.894), but not for TW2 (r=0.490).</p><p><strong>Conclusion: </strong>BoneView demonstrated comparable accuracy to radiologist-assessed GP method and outperformed TW2 assessments in this cohort. AI-based systems may enhance consistency in pediatric bone age estimation but require careful validation, especially in ethnically diverse populations.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138275","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":"When sickle cell disease strikes the orbits: a rare pediatric case of bilateral subperiosteal hematomas.","authors":"Salma El Kadiri, Kamal Hlioui, Loubna Messari, Hind Qajia, Latifa Chat, Siham El Haddad","doi":"10.1007/s00247-025-06404-1","DOIUrl":"https://doi.org/10.1007/s00247-025-06404-1","url":null,"abstract":"<p><p>Bone infarctions can occasionally involve the orbit, presenting with subperiosteal hematomas and mimicking infectious or neoplastic processes. We report a case of bilateral orbital bone infarctions complicated by subperiosteal hematomas in a child with sickle cell disease during a vaso-occlusive crisis. The diagnosis of subperiosteal orbital hematoma was established by computed tomography. Differentiating infection on imaging was essential to guide management. Surgical decompression was performed, leading to marked clinical improvement and relief of optic nerve compression. This case illustrates the importance of prompt diagnosis and intervention in rare orbital complications associated with hemoglobinopathies.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125491","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":"Comment: an important step forward in interpreting liver stiffness values in Fontan patients.","authors":"Tyler J Fraum","doi":"10.1007/s00247-025-06401-4","DOIUrl":"https://doi.org/10.1007/s00247-025-06401-4","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081188","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":"From competition to collaboration: reframing the narrative of women in pediatric radiology.","authors":"Rama S Ayyala, Desi M Schiess, Aki Tanimoto, Cynthia K Rigsby","doi":"10.1007/s00247-025-06378-0","DOIUrl":"https://doi.org/10.1007/s00247-025-06378-0","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065305","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}