Pediatric Radiology最新文献

{"title":"Imaging and clinical features of intra-abdominal injuries in children with suspected physical abuse.","authors":"Tagrid M Ruiz-Maldonado, M Katherine Henry, Esther Ro, Shashank S Prasad, Anna Kalathil Thomas","doi":"10.1007/s00247-025-06335-x","DOIUrl":"https://doi.org/10.1007/s00247-025-06335-x","url":null,"abstract":"<p><p>The effective diagnosis and management of inflicted intra-abdominal injuries require a comprehensive, collaborative evaluation that includes a thorough understanding of the clinical presentation, laboratory findings, injury mechanisms, and potential clinical outcomes. This review presents the various aspects of inflicted intra-abdominal injuries, including the clinical presentation, mechanisms of injury, and the utility of available screening and imaging tools. The specific types of solid organ and hollow viscus injuries relevant to child physical abuse and their imaging appearance are also discussed. Radiological imaging provides critical information that can help treating providers contextualize the history obtained and the injuries identified, highlighting the value of close collaboration among radiologists, child abuse pediatricians, and other members of the clinical team when concerns for abuse arise.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768918","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":"Incidence and factors associated with serosal and soft tissue enhancement after cardiac catheterization in infants.","authors":"Akhil Dhamija, Joshua D Wermers, Sarosh P Batlivala, Yinan Li, Bin Zhang, Alexander J Towbin","doi":"10.1007/s00247-025-06343-x","DOIUrl":"https://doi.org/10.1007/s00247-025-06343-x","url":null,"abstract":"<p><strong>Background: </strong>Diffuse serosal and soft tissue enhancement is a rare imaging phenomenon observed in infants following cardiac catheterization. The appearance of serosal and soft tissue enhancement can mimic pneumoperitoneum, potentially leading to misdiagnosis and unnecessary diagnostic procedures. While serosal and soft tissue enhancement has been documented in case reports, no studies have systematically evaluated the risk factors associated with its development.</p><p><strong>Objective: </strong>To determine the frequency of serosal and soft tissue enhancement in infants following cardiac catheterization and identify clinical and imaging factors associated with this phenomenon.</p><p><strong>Materials and methods: </strong>This retrospective study analyzed infants who underwent cardiac catheterization at our institution between January 2010 and September 2019. Abdominal radiographs obtained within 2 days of the procedure were independently reviewed by three pediatric radiologists for the presence of serosal and soft tissue enhancement. Clinical data, including contrast dose, renal function, and cardiac physiology, were extracted from the electronic medical record. Statistical analysis, including t-tests and logistic regression, was performed to identify factors associated with serosal and soft tissue enhancement, with inter-observer reliability assessed using the Fleiss kappa test.</p><p><strong>Results: </strong>Among 1,796 infants who underwent cardiac catheterization, 294 had follow-up abdominal radiographs. Serosal and soft tissue enhancement was identified as present by all three radiologists in 21 patients (7.1%). Significant factors associated with serosal and soft tissue enhancement included lower pre- and post-catheterization creatinine levels (pre- 0.36 ± 0.17 vs 0.46 ± 0.30 mg/dL; P=0.043; post- 0.35 ± 0.11 vs 0.45 ± 0.29 mg/dL; P=0.009), higher contrast volume (31.8 ± 21.4 vs 21.0 ± 18.1 mL; P=0.013), and higher contrast volume per body surface area (123.0 ± 69.2 vs 80.8 ± 56.2 mL/m^2; P=0.002). Serosal and soft tissue enhancement occurred more frequently in patients with bi-ventricular cardiac physiology (125/294; 42.5% compared to 169/294; 57.5%).</p><p><strong>Conclusion: </strong>Serosal and soft tissue enhancement occurs in a small proportion of neonates following cardiac catheterization and is associated with higher contrast dosages and body surface area-adjusted contrast volumes. Awareness of serosal and soft tissue enhancement among pediatric radiologists is helpful to avoid misdiagnosis of pneumoperitoneum.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768919","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":"Hermes.","authors":"","doi":"10.1007/s00247-025-06360-w","DOIUrl":"https://doi.org/10.1007/s00247-025-06360-w","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760752","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":"Encephalocraniocutaneous lipomatosis-a neuroradiological perspective.","authors":"Dhrumil Deveshkumar Patel, Karen W Gripp, Paige Mcdunnah, Ishita Mishra, Vinay Kandula","doi":"10.1007/s00247-025-06346-8","DOIUrl":"https://doi.org/10.1007/s00247-025-06346-8","url":null,"abstract":"<p><p>This report aims to demonstrate the phenotypic, radiological, and genetic features of encephalocraniocutaneous lipomatosis (ECCL), a rare neurocutaneous disorder characterized by a distinct triad of congenital skin lesions, ocular anomalies, and central nervous system (CNS) abnormalities. The mosaic nature of ECCL puts the radiologist in a unique position to facilitate its prompt diagnosis. In the patient reported here, pulmonic stenosis and facial dysmorphism initially raised the suspicion of Noonan syndrome, which was unsupported by genetic testing. Serial imaging revealed multiple intracranial lipomas and glioma along with a clinically evident nevus psiloliparus, prompting further genetic evaluation. This identified a novel de novo variant in FGFR1 (c.1685A > C, p.Glu562Ala). The variant appeared heterozygous in blood and cheek swab cells derived DNA, contrasting with the typical mosaic nature of variants in ECCL.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760751","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":"Quantitative ultrasound-derived fat fraction for identifying pediatric patients with metabolic dysfunction-associated steatotic liver disease: a prospective study.","authors":"Yunlin Huang, Chao Sun, Juan Cheng, Ying Wang, Yijie Qiu, Shiwen Wang, Ming Wang, Li Wei, Rui Cheng, Jian-Gao Fan, Yi Dong","doi":"10.1007/s00247-025-06349-5","DOIUrl":"https://doi.org/10.1007/s00247-025-06349-5","url":null,"abstract":"<p><strong>Background: </strong>Metabolic dysfunction-associated steatotic liver disease is increasingly affecting younger populations. Ultrasound-derived fat fraction is a technique used in ultrasound to quantify liver fat content. The diagnostic performance of ultrasound-derived fat fraction in pediatric patients with metabolic dysfunction-associated steatotic liver disease is yet to be evaluated.</p><p><strong>Objective: </strong>To evaluate the diagnostic performance of ultrasound-derived fat fraction measurement in detecting and grading hepatic steatosis in pediatric patients with metabolic dysfunction-associated steatotic liver disease.</p><p><strong>Materials and methods: </strong>In this prospective study, pediatric patients diagnosed with metabolic dysfunction-associated steatotic liver disease were enrolled. Six acquisitions of ultrasound-derived fat fraction were obtained. Taking magnetic resonance imaging (MRI)-proton density fat fraction as a reference standard, the area under the receiver operating characteristic curve (AUC) was performed to evaluate the diagnostic performance of ultrasound-derived fat fraction. Youden index was used to determine the cutoff value of ultrasound-derived fat fraction. Correlation coefficient and Bland-Altman plot were performed.</p><p><strong>Results: </strong>From April 2024 to March 2025, 32 patients (median age, 12 years; median body mass index, 29.7 kg/m²) were included. The ultrasound-derived fat fraction values showed a positive correlation with MRI-proton density fat fraction (r = 0.72). The ultrasound-derived fat fraction values and MRI-proton density fat fraction had a mean bias of 3.3% (95% limits of agreement: -16.4, 23.1). Using MRI-proton density fat fractions ≥ 5%, ≥ 15%, and ≥ 25% as the reference standard for diagnosing hepatic steatosis grade ≥ S1, ≥ S2, and S3, the AUCs of ultrasound-derived fat fraction were 0.84, 0.88, and 0.88, with the cutoff values of 9.5%, 10.5%, and 12.8%, respectively.</p><p><strong>Conclusion: </strong>Ultrasound-derived fat fraction demonstrates promising diagnostic performance for detecting and grading hepatic steatosis in pediatric patients with metabolic dysfunction-associated steatotic liver disease within this cohort.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760753","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":"Temporary transvenous external pacing for cardiac MRI in a pediatric patient.","authors":"Mehrad Rokni, Shotaro Naganawa, Misagh Piran, Daniel Cortez, Ahmadreza Ghasemiesfe","doi":"10.1007/s00247-025-06325-z","DOIUrl":"https://doi.org/10.1007/s00247-025-06325-z","url":null,"abstract":"<p><p>This report discusses the use of temporary transvenous external cardiac pacing during cardiac magnetic resonance imaging (MRI). Despite its feasibility having been explored in adults, its application in pediatric patients is not well established. We present a case of a 6-year-old female with a high-degree atrioventricular (AV) block managed with an externalized temporary pacing system for MRI. This system enabled cardiac MRI for further treatment planning, eliminating the immediate need for permanent pacemaker implantation. This case underscores the feasibility of conducting cardiac MRI in pediatric patients requiring temporary pacing, contingent upon the utilization of appropriate equipment and protocols.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753971","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":"Antenatal subpial hemorrhage diagnosed by fetal magnetic resonance imaging: imaging spectrum and autopsy findings.","authors":"Stephanie Libzon, Debora Kidron, Uri Erlik, Karina Krajden-Haratz, Moran Hausman-Kedem, Liat Ben Sira","doi":"10.1007/s00247-025-06353-9","DOIUrl":"https://doi.org/10.1007/s00247-025-06353-9","url":null,"abstract":"<p><p>Subpial hemorrhage is a rare intracranial hemorrhage typically described in neonates. We report the first prenatal diagnosis of subpial hemorrhage in a 28-year-old primigravida, defined on fetal magnetic resonance imaging (MRI) by its hallmark cortical inward depression (\"cortical buckling\") and restricted diffusion on the apparent diffusion coefficient map, and later confirmed by autopsy. This case implicates intrinsic fetal factors-rather than birth trauma or neonatal asphyxia-in subpial hemorrhage pathogenesis and highlights the critical role of fetal MRI in distinguishing subpial hemorrhage from other fetal hemorrhages, with important implications for prenatal counseling and perinatal management.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144743850","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":"Bidimensional shear wave spleen elastography for diagnosis and grading of esophageal varices in children with portal hypertension.","authors":"Cecilia Mackintosh, Julio Sebastian Kaplan, Alejandra Yanet Prati, Silvina Denise Ruvinsky, Macarena Roel, Adriana Bottero, Esteban Pablo Dardanelli","doi":"10.1007/s00247-025-06351-x","DOIUrl":"https://doi.org/10.1007/s00247-025-06351-x","url":null,"abstract":"<p><strong>Background: </strong>Portal hypertension in children can result from a wide range of liver diseases, both cirrhotic and non-cirrhotic. Non-invasive diagnosis of esophageal varices, a potentially life-threatening complication, is of utmost importance in these patients.</p><p><strong>Objective: </strong>To assess the agreement between spleen stiffness by bidimensional shear wave elastography (2D SWE) and endoscopic findings (presence and grading of esophageal varices) in pediatric patients with portal hypertension.</p><p><strong>Materials and methods: </strong>Single-center retrospective observational study between February 2021 and August 2024. Data from pediatric patients (< 18 years old) who underwent esophagogastroduodenoscopy within a month of a grayscale ultrasound including spleen elastography were collected. Patients were divided into three groups: varices-free, low-risk varices, and high-risk varices (enlarged tortuous varices with red color sign, or large size varices). The area under the receiver operating characteristic curve (AUROC), positive predictive value (PPV), and negative predictive value (NPV) were estimated.</p><p><strong>Results: </strong>We included 163 patients (86 males, 77 females; median age: 9 years (interquartile range (IQR) 6-13 years)). The sample included 80 varices-free (49%), 38 low-risk varices (23%), and 45 high-risk varices (28%) cases. The median spleen elastography was 20 kPa (2.58 m/s), 34 kPa (3.36 m/s), and 40 kPa (3.65 m/s) in the varices-free, low-risk, and high-risk varices groups, respectively. When a cut-off value of 28.5 kPa (3.08 m/s) was used to detect varices of any grade, the sensitivity was 93% (95% confidence interval: 85-97), the specificity was 94% (86-98), PPV 94% (86-98), and NPV 93% (85-97). An AUROC of 0.93 (0.90-0.98) was obtained. When comparing the high versus low-risk varices groups, using a cut-off point of 35.35 kPa (3.43 m/s), we obtained an AUROC of 0.66, with a sensitivity of 71%, specificity of 61%, PPV 68%, and NPV of 64%.</p><p><strong>Conclusion: </strong>Spleen stiffness by bidimensional shear wave elastography showed excellent diagnostic performance for detecting esophageal varices in children with portal hypertension and a moderate performance for distinguishing patients with low-risk varices from those with high-risk varices.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144743851","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":"Developmental dysplasia of the hip: ultrasound evaluation.","authors":"Jillian Krauss, Marcelo Straus Takahashi, Jonathan Samet","doi":"10.1007/s00247-025-06334-y","DOIUrl":"https://doi.org/10.1007/s00247-025-06334-y","url":null,"abstract":"<p><p>Developmental dysplasia of the hip (DDH) is a commonly encountered pathology in everyday pediatric radiology practice. Early detection of the condition and early institution of therapy are crucial in optimizing patient outcomes and preventing long-term morbidity. Ultrasound is the imaging modality of choice in evaluating DDH in patients less than 4 months of age and is also used to evaluate infants undergoing treatment with an abduction device to monitor therapy response. This article will begin with a general review of DDH, including the underlying pathophysiology of the condition and which patients meet screening criteria for developmental hip dysplasia ultrasound assessment. The paper will then describe the ultrasound techniques utilized in screening for DDH and how to apply the Graf classification system to determine if a hip is normal or dysplastic, as well as how to grade the severity of dysplasia. Finally, the paper will address specialized ultrasound techniques used to follow patients undergoing treatment with an abduction device to monitor therapy response.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732634","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":"Development and validation of a cranial ultrasound imaging-based deep learning model for periventricular-intraventricular haemorrhage detection and grading: a two-centre study.","authors":"Yahui Peng, Zhensheng Hu, Mianmian Wen, Yishu Deng, Dan Zhao, Yuwei Yu, Weixiang Liang, Xianhua Dai, Yi Wang","doi":"10.1007/s00247-025-06327-x","DOIUrl":"https://doi.org/10.1007/s00247-025-06327-x","url":null,"abstract":"<p><strong>Background: </strong>Periventricular-intraventricular haemorrhage (IVH) is the most prevalent type of neonatal intracranial haemorrhage. It is especially threatening to preterm infants, in whom it is associated with significant morbidity and mortality. Cranial ultrasound has become an important means of screening periventricular IVH in infants. The integration of artificial intelligence with neonatal ultrasound is promising for enhancing diagnostic accuracy, reducing physician workload, and consequently improving periventricular IVH outcomes.</p><p><strong>Objectives: </strong>The study investigated whether deep learning-based analysis of the cranial ultrasound images of infants could detect and grade periventricular IVH.</p><p><strong>Materials and methods: </strong>This multicentre observational study included 1,060 cases and healthy controls from two hospitals. The retrospective modelling dataset encompassed 773 participants from January 2020 to July 2023, while the prospective two-centre validation dataset included 287 participants from August 2023 to January 2024. The periventricular IVH net model, a deep learning model incorporating the convolutional block attention module mechanism, was developed. The model's effectiveness was assessed by randomly dividing the retrospective data into training and validation sets, followed by independent validation with the prospective two-centre data. To evaluate the model, we measured its recall, precision, accuracy, F1-score, and area under the curve (AUC). The regions of interest (ROI) that influenced the detection by the deep learning model were visualised in significance maps, and the t-distributed stochastic neighbour embedding (t-SNE) algorithm was used to visualise the clustering of model detection parameters.</p><p><strong>Results: </strong>The final retrospective dataset included 773 participants (mean (standard deviation (SD)) gestational age, 32.7 (4.69) weeks; mean (SD) weight, 1,862.60 (855.49) g). For the retrospective data, the model's AUC was 0.99 (95% confidence interval (CI), 0.98-0.99), precision was 0.92 (0.89-0.95), recall was 0.93 (0.89-0.95), and F1-score was 0.93 (0.90-0.95). For the prospective two-centre validation data, the model's AUC was 0.961 (95% CI, 0.94-0.98) and accuracy was 0.89 (95% CI, 0.86-0.92).</p><p><strong>Conclusion: </strong>The two-centre prospective validation results of the periventricular IVH net model demonstrated its tremendous potential for paediatric clinical applications. Combining artificial intelligence with paediatric ultrasound can enhance the accuracy and efficiency of periventricular IVH diagnosis, especially in primary hospitals or community hospitals.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732633","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}