Pediatric Radiology最新文献

{"title":"Internal carotid artery arteritis as a rare complication of pediatric otomastoiditis: serial magnetic resonance imaging and magnetic resonance angiography findings.","authors":"Carmela Russo, Chiara Di Domenico, Pietro Spennato, Sara Lombardi, Giuseppe Mirone, Eugenio Covelli, Giuseppe Cinalli","doi":"10.1007/s00247-026-06578-2","DOIUrl":"10.1007/s00247-026-06578-2","url":null,"abstract":"<p><p>Acute otomastoiditis is a common pediatric infection that may rarely lead to severe intracranial complications. The frequency of otomastoiditis, and even more so the frequency of intracranial complications, significantly increased after the end of the coronavirus disease 19 pandemic. We report a 14-month-old boy with bilateral otomastoiditis complicated by extensive venous sinus thrombosis, petrous apicitis, and progressive infectious arteritis of the cavernous internal carotid artery. Serial magnetic resonance imaging and magnetic resonance angiography demonstrated interval internal carotid artery narrowing with vessel wall enhancement, subsequent arterial occlusion, and focal ischemic injury. Despite these findings, the patient remained neurologically intact and showed radiologic improvement at follow-up. This case highlights a rare arterial complication of pediatric otomastoiditis and underscores the importance of comprehensive and serial vascular imaging for early detection, differentiation from extrinsic compression, and guidance of multidisciplinary management.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"1183-1188"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147434676","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":"Super-resolution MRI-derived brainstem and cerebellar volumes in fetuses between 22 weeks and 32 weeks of gestation.","authors":"Matthew Taing, Camilo Calixto, Onur Afacan, Maria Camila Cortes-Albornoz, Suely Fazio Ferracioll, Sergio Valencia, Clemente Velasco-Annis, Simon K Warfield, Camilo Jaimes","doi":"10.1007/s00247-026-06574-6","DOIUrl":"10.1007/s00247-026-06574-6","url":null,"abstract":"<p><strong>Background: </strong>The posterior fossa undergoes rapid development in utero, yet normative volumetric data are limited, especially during mid-gestation when most fetal MRIs are performed.</p><p><strong>Objective: </strong>This study aimed to develop a segmentation method tailored to the fetal posterior fossa and establish normative growth trajectories for key infratentorial structures between 22 weeks and 32 weeks of gestation.</p><p><strong>Materials and methods: </strong>Eighty-five pregnant women were prospectively recruited at a single institution. Inclusion criteria were normal singleton pregnancies between 19-40 weeks' gestation and maternal age 18-45 years. Exclusion criteria included fetal abnormalities, MRI contraindications, or significant maternal comorbidities. Eighteen fetuses were excluded, resulting in 67 normal fetuses (43 male, 24 female). Imaging was performed at 3 T using multiplanar T2-weighted sequences, reconstructed into isotropic volumes after motion correction and brain extraction. Segmentation labels were created using age-specific atlases from the Developing Human Connectome Project. Expert annotations defined the midbrain, pons, medulla, vermis, and cerebellar hemispheres. Images were registered to the atlases using the Symmetric Normalization (SyN) algorithm, with labels manually verified by a pediatric neuroradiologist. Volumes were normalized to total brain volume and analyzed using linear regression with gestational age and sex as predictors.</p><p><strong>Results: </strong>Absolute volumes of all posterior fossa structures significantly increased with gestational age (P<0.001), showing strong linear associations (R²=0.80-0.87). The cerebellum exhibited the steepest growth (β=1,056.01, R²=0.87, P<0.001). Growth was symmetric with no significant left-right differences. Relative volumetric trends varied: the cerebellum increased proportionally (β=0.007, P<0.001), while the midbrain, pons, and medulla decreased relative to total brain volume. The vermis showed no significant association with gestational age but had sex-specific effects; males had smaller relative vermian volumes than females (β=-0.43, P=0.04), despite larger absolute posterior fossa volumes overall.</p><p><strong>Conclusions: </strong>This study provides normative volumetric references for fetal posterior fossa structures between 22-32 weeks' gestation using a novel segmentation method. Absolute growth followed linear patterns, while relative measures revealed sex-specific variations in the vermis and cerebellum. These benchmarks may enhance diagnostic accuracy for detecting posterior fossa anomalies in clinical fetal MRI.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"1120-1129"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147474913","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 new 15-month pathway for pediatric radiology subspecialty in diagnostic radiology residency: opportunities, challenges, and future considerations.","authors":"Arif Musa, Mohammed Twam, Hailey Carruthers, Gulcin Altinok, Ali Harb, Mahmoud Anteet, Sheena Saleem","doi":"10.1007/s00247-026-06562-w","DOIUrl":"https://doi.org/10.1007/s00247-026-06562-w","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147817926","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":"Cardiac MRI with metric optimized gating in pediatric patients with ventricular bigeminy.","authors":"Harris Wang, Datta Singh Goolaub, Israel Valverde, Christopher K Macgowan, Navjot Gill, Andrea Young, Shi-Joon Yoo","doi":"10.1007/s00247-026-06581-7","DOIUrl":"10.1007/s00247-026-06581-7","url":null,"abstract":"<p><p>Cardiovascular magnetic resonance cine imaging is limited in patients with an irregular cardiac rhythm as electrocardiographic gating requires a regular rhythm during image data acquisition. We describe a novel approach for imaging pediatric patients with ventricular bigeminy, using artificial triggering followed by metric optimized gating (MOG) reconstruction. This technique allows for the reconstruction of diagnostic quality images and permits quantitative flow and volumetric analyses. Unlike conventional methods of arrhythmia suppression or exclusion, this technique preserves the abnormal arrhythmic cycle, enabling a more comprehensive understanding of the patient's true hemodynamic physiology.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"1174-1178"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147481219","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":"Strategies for radiology faculty recruitment and retention in a competitive market: implications for pediatric radiology.","authors":"Sergio Valencia, Camilo Jaimes, Teresa Victoria, Michael S Gee","doi":"10.1007/s00247-026-06597-z","DOIUrl":"10.1007/s00247-026-06597-z","url":null,"abstract":"<p><p>This narrative review examines strategies and recommendations to address the current radiologist shortage in the USA, with a particular emphasis on workforce retention and preservation through operational efficiency, organizational leadership, cultural transformation, and technology integration. National workforce data, expert commentaries, and strategic frameworks from academic radiology and healthcare leadership literature were reviewed to contextualize current challenges and proposed solutions. The radiology workforce faces escalating pressure driven by rapidly increasing imaging volumes, limited growth in the number of practicing radiologists, and rising attrition rates. Between 2008 and 2018, radiologist workloads nearly doubled while workforce expansion was much smaller, exacerbating workload imbalance, burnout, and professional dissatisfaction. The COVID-19 pandemic exacerbated workforce challenges by causing an exodus of workers and making on-site work more challenging. Although short-term mitigation strategies exist, sustainable long-term solutions require coordinated cultural and structural changes that prioritize strategic hiring, transparent career advancement pathways, protected academic and professional development time, and optimized workflow efficiency supported by technology. In conclusion, effective management of the radiology workforce shortage necessitates integrated operational and cultural approaches, with departments implementing comprehensive and tailored interventions to expand workforce capacity, enhance professional fulfillment, and maintain high-quality patient care.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"1068-1077"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639398","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":"Diagnostic accuracy of artificial intelligence-assisted infant hip ultrasound interpretation for developmental dysplasia of the hip: systematic review and meta-analysis.","authors":"Aryan Azmi, Adam McArthur, Steel McDonald, Abhilash Hareendranathan, Jacob Jaremko","doi":"10.1007/s00247-026-06601-6","DOIUrl":"10.1007/s00247-026-06601-6","url":null,"abstract":"<p><strong>Background: </strong>Ultrasound is the standard imaging test for infant developmental dysplasia of the hip (DDH) but is highly operator-dependent, leading to variable image quality and classification. Artificial intelligence (AI)-assisted ultrasound may standardize acquisition and interpretation and support DDH screening beyond specialist centers.</p><p><strong>Objective: </strong>To evaluate the diagnostic accuracy and feasibility of AI-assisted ultrasound for infant DDH.</p><p><strong>Materials and methods: </strong>We performed a systematic review and diagnostic test-accuracy meta-analysis of studies enrolling infants (≤12 months) undergoing hip ultrasound, in which the index test was AI applied to two-dimensional (2D) or three-dimensional (3D) ultrasound and the reference standard was expert Graf-based interpretation or follow-up consensus. Risk of bias was assessed with QUADAS-2 (diagnostic accuracy bias tool). Sensitivity and specificity were pooled with a bivariate random-effects model.</p><p><strong>Results: </strong>Twenty-nine studies were eligible; nine provided 2×2 data (6,351 hips) for pooling. Pooled sensitivity was 0.92 (95% CI 0.86-0.95) and specificity 0.96 (95% CI 0.91-0.98). Risk of bias was frequently high or unclear for patient selection and the index test. Feasibility signals included short operator training times (approx. 1-2 h) and scan acquisition time reductions (approx. 20-50%), while economic reporting was limited.</p><p><strong>Conclusion: </strong>AI-assisted ultrasound demonstrates high diagnostic accuracy for infant DDH and may help standardize hip imaging and facilitate safe use by nonexpert operators, but larger multicenter studies with external validation and robust economic evaluation are needed.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"1165-1173"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646243","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":"Streamlining pediatric musculoskeletal infection workup: the why, what, and how of rapid MRI protocols.","authors":"Rohan M Shah, Ashishkumar K Parikh, Romie F Gibly, Jonathan D Samet","doi":"10.1007/s00247-026-06552-y","DOIUrl":"10.1007/s00247-026-06552-y","url":null,"abstract":"<p><p>Acute musculoskeletal infection is a common pediatric emergency that requires early diagnosis and management, without which adverse sequelae can include functional impairment, limb deformities, persistent infection, progression to sepsis, and mortality. Magnetic resonance imaging (MRI) is the gold standard for diagnosis. In recent years, there has been growing interest in the use of rapid MRI protocols for acute pediatric musculoskeletal infection, with benefits including quicker scan times with decreased need for sedation and contrast. In the present study, we discuss key considerations, practical challenges, and clinical applications of rapid musculoskeletal MRI in children. We also include various case examples of rapid MRI scans with a practical guide for interpretation to be used by the practicing radiologist. Rapid MRI protocols ultimately present a powerful diagnostic tool that can condense the workup of patients being evaluated for acute musculoskeletal infection, and their incorporation into hospital systems should continue to be investigated.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"1008-1017"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges of after-hours pediatric imaging.","authors":"Michael R Aquino, Jignesh Shah, Summer L Kaplan","doi":"10.1007/s00247-025-06473-2","DOIUrl":"10.1007/s00247-025-06473-2","url":null,"abstract":"<p><p>The after-hours period presents unique challenges for pediatric radiologists. These stem from the higher percentage of high acuity/emergent studies, limited staffing, and the adverse effects of non-traditional hours on radiologists' health and performance. This article describes the current landscape of after-hours pediatric radiology coverage, workflow, and staffing challenges, and reviews the impact that disruptions in circadian rhythm can have on health and performance.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"969-978"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145637120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic and management challenge of a pediatric H3K27-altered glioma masquerading as vestibular schwannoma.","authors":"Jinquan Chen, Qiufeng Yin, Haibo Zhang","doi":"10.1007/s00247-025-06507-9","DOIUrl":"10.1007/s00247-025-06507-9","url":null,"abstract":"<p><p>Pediatric H3K27-altered glioma most frequently arises from midline cerebral parenchyma, whereas intracranial extra-axial locations are exceedingly rare. We report the case of an 8-year-old boy who presented with chronic-onset left-sided hearing impairment and peripheral facial paralysis. Radiological imaging identified an isolated cerebellopontine angle lesion distinct from surrounding structures. A vestibular schwannoma was diagnosed based on preoperative examinations. Surgical resection revealed an unusual facial nerve-infiltrating mass with distinct vascular features. Histopathological assessment yielded an unexpected diagnosis of H3K27-altered diffuse midline glioma, contrasting with initial preoperative impressions. This exceptional case illustrates diagnostic pitfalls in pediatric skull base pathologies and expands the recognized spectrum of diffuse midline gliomas.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"1179-1182"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146181783","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 changes in diffusion MRI metrics along the perivascular space in children during the first 5 years of life.","authors":"Maria Camila Cortes-Albornoz, Sergio Valencia, Jeremy N Ford, Natalia Sofia Cortes-Albornoz, Camilo Calixto, Shohei Fujita, Robert Frost, Lilla Zöllei, Camilo Jaimes","doi":"10.1007/s00247-026-06585-3","DOIUrl":"10.1007/s00247-026-06585-3","url":null,"abstract":"<p><strong>Background: </strong>The glymphatic system contributes to waste clearance in the brain and helps in maintaining neural health.</p><p><strong>Objective: </strong>This study aimed to evaluate the age-related changes in magnetic resonance imaging (MRI) measurements of the index of diffusivity along the perivascular space (Along the Perivascular Space (ALPS) index) in infants and children less than 5 years of age.</p><p><strong>Materials and methods: </strong>This IRB-approved, HIPAA-compliant study utilized diffusion-weighted MRI data from the Baby Connectome Project (BCP), which scanned developing subjects between birth and 5 years. We randomly selected subjects older than 2 months without significant imaging artifacts. The ALPS index was computed using diffusion tensor imaging (DTI)-derived diffusivity metrics along projection and association fibers. Multivariable linear regression and ANOVA were used to assess the impact of age, sex, and motion on ALPS index values across hemispheres and age groups.</p><p><strong>Results: </strong>We analyzed 60 cases (58% female; mean age=25.4 months). ANOVA demonstrated higher right-hemisphere ALPS values in the 12-24-month, 37-48-month, and 49-65-month groups compared to the 2-12-month group (P<0.05), with no significant differences in the left hemisphere or average index, except in the 49-65-month group. Linear regression showed age as a positive predictor of ALPS values (P<0.001). Sex and head motion had no significant effects.</p><p><strong>Conclusion: </strong>ALPS index values increase with age during the first 5 years of life, particularly in the right hemisphere, suggesting early developmental asymmetry in perivascular water diffusivity. These findings provide normative reference data and may inform future pediatric neuroimaging studies.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"1130-1138"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147491570","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}