Pediatric Radiology最新文献

{"title":"Intra- and interobserver agreement in evaluation of image-defined risk factors on computed tomography in pediatric neuroblastoma.","authors":"Yaw Amoako-Tuffour, Ian MacDonald, Tahani Ahmad, Irit Maianski, Ziad Farhat, Afshin Ansari, Mareen Sarah Kraus, Craig Erker, Rodrigo Romao, Rahim Moineddin, Teresa Fortuna, Kathleen O'Brien, Daddy Mata-Mbemba","doi":"10.1007/s00247-024-06138-6","DOIUrl":"10.1007/s00247-024-06138-6","url":null,"abstract":"<p><strong>Background: </strong>Image-defined risk factors (IDRFs) were introduced to provide a consensus approach for pre-treatment risk stratification on computed tomography (CT) and magnetic resonance imaging (MRI) in patients with neuroblastoma.</p><p><strong>Objective: </strong>To assess the intra- and inter-reader agreement of radiologists in identifying IDRFs on CT.</p><p><strong>Materials and methods: </strong>Approval for this retrospective study was granted by our institutional research ethics board with a waiver of consent. CT studies of pediatric patients with neuroblastoma were assessed by seven radiologists in two rounds. Each CT was accompanied by a standard form to indicate presence or absence of IDRFs for each patient. At least a 4-week period between rounds, randomization, and relabeling of the CT studies was required to minimize recall bias. Finally, three of the seven radiologists conducted a subsequent consensus reading to determine true positive IDRFs in the cohort. Fleiss' kappa statistic was used to evaluate readers' agreements and Pearson's correlation assessed the correlation between years of experiences of radiologists and their performance in accurately (intra-reader agreement) detecting IDRFs.</p><p><strong>Results: </strong>A total of 31 children with a median age of 2.1 years (interquartile range (IQR) 1.1, 3.0; range 0-18; male=21 (67.7%)) were included and 251 total positive IDRFs were identified on their CT scans. The location of the primary tumor was in the neck in 1 patient (3.2%), within the chest in 2 patients (6.5%), within the abdomen in 27 patients (87.1%), and in the pelvis in 1 patient (3.2%). In determining IDRFs, the inter-reader agreement among radiologists was substantial: 0.65 (95% CI 0.60, 0.69) and the intra-reader agreement for each radiologist was substantial to near perfect, ranging from 0.67 (0.60, 0.70) to 0.86 (0.82, 0.90). The correlation between the number of years of experience of radiologists and their performances in accurately detecting IDRFs (their intra-reader agreements) was respectively low (r=45, P=0.30) for abdomino-pelvic IDRFs and high for organs' infiltration IDRFs (r=0.74, P=0.05).</p><p><strong>Conclusion: </strong>The determination of IDRFs on CT is reproducible with significant agreement among radiologists. The two IDRF items with the lowest overall inter-reader agreements were \"diaphragm infiltration\" and \"mesenteric infiltration.\"</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"305-311"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915481","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":"Cerebellar hemorrhage in neonates: pattern analysis by ultrasonography and magnetic resonance imaging.","authors":"Gayoung Choi, Young Hun Choi, Seul Bi Lee, Yeon Jin Cho, Seunghyun Lee, Jung-Eun Cheon, Seung Han Shin, Bo-Kyung Je","doi":"10.1007/s00247-024-06126-w","DOIUrl":"10.1007/s00247-024-06126-w","url":null,"abstract":"<p><strong>Background: </strong>Cerebellar hemorrhage in neonates is increasingly being identified but is still underdiagnosed. While magnetic resonance imaging (MRI) is the optimal imaging modality for cerebellar hemorrhage evaluation, ultrasonography (US) is commonly used for screening. Characterizing the patterns and distribution of cerebellar hemorrhage lesions can help facilitate its detection by aiding to focus on prevailing type of cerebellar hemorrhage.</p><p><strong>Objective: </strong>This study aimed to analyze the patterns of cerebellar hemorrhage in neonates, comparing US findings with MRI.</p><p><strong>Materials and methods: </strong>This was a retrospective study of 765 neonatal intensive care unit (NICU)-admitted neonates who underwent brain MRI due to various clinical and radiological requirements. Two pediatric radiologists reviewed brain MRI and US in consensus, and cerebellar hemorrhage patterns were classified based on MRI findings: type 1, punctate cerebellar hemorrhage without cerebellar volume loss; type 2, focal cerebellar hemorrhage with cerebellar volume loss; type 3, ovoid/crescent cerebellar hemorrhage in the periphery of the cerebellar hemisphere; type 4, isolated vermian cerebellar hemorrhage; type 5, cerebellar hemorrhage involving almost the entire cerebellar hemisphere. The distribution and US detection rates of cerebellar hemorrhage were compared according to the cerebellar hemorrhage type.</p><p><strong>Results: </strong>A total of 56 (33 male, 23 female) cases (7.32%) among 765 MRIs showed cerebellar hemorrhage (median gestational age, 27 + 1 weeks [IQR 5 + 2]; median birth weight, 955 g [IQR 882.5]). The most common pattern was type 1 (60.7%). Type 3 cerebellar hemorrhage was more commonly observed in the inferior and peripheral cerebellum compared to types 1 and 2 cerebellar hemorrhage (P=0.002). In retrospective review of images, type 3 was the most commonly missed type of cerebellar hemorrhage (initial US detection rate, 33.3%; retrospective US detection rate, 75%).</p><p><strong>Conclusion: </strong>This study underscores the importance of understanding cerebellar hemorrhage patterns and suggests that careful inspection of inferior and periphery of the cerebellum is important to avoid missed diagnosis of cerebellar hemorrhage.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"324-333"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927589","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":"Huge extrahepatic gallstone on percutaneous transhepatic biliary drainage tip-a pediatric case report.","authors":"Anna-Maria Odenthal, Carsten Meyer, Mark Born, Martin Heimbrodt, Julian Luetkens, Martha Dohna","doi":"10.1007/s00247-024-06156-4","DOIUrl":"10.1007/s00247-024-06156-4","url":null,"abstract":"<p><p>Biliary strictures, which are common in the first year after pediatric liver transplantation, are diagnosed and managed with percutaneous transhepatic cholangiography. In children undergoing percutaneous transhepatic cholangiography, early cholangitis is the most common complication while typical catheter-related complications are obstruction, dislodgement, kinking, or fracture. This case report discusses the unique presentation and management of a 5-year-old girl with an incidental percutaneous transhepatic biliary drainage-associated extrahepatic gallstone formation following treatment of biliary stricture after pediatric liver transplantation. It was effectively treated with percutaneous transhepatic lithotripsy. Although this is a rare but potentially harmful complication, in case of resistance at drainage removal, a drainage-tip stone should be excluded by ultrasound or fluoroscopy.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"347-351"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009437","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":"Response to Letter to Editor.","authors":"Venkatram Krishnan, Arabinda K Choudhary","doi":"10.1007/s00247-024-06161-7","DOIUrl":"10.1007/s00247-024-06161-7","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"369-370"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009439","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 performance of contrast-enhanced ultrasound in traumatic solid organ injuries in children: a systematic review and meta-analysis.","authors":"Payam Jannatdoust, Parya Valizadeh, Amir Hassankhani, Melika Amoukhteh, Delaram J Ghadimi, Mahsa Heidari-Foroozan, Paniz Sabeghi, Paniz Adli, Jennifer H Johnston, Pauravi S Vasavada, Ali Gholamrezanezhad","doi":"10.1007/s00247-024-06127-9","DOIUrl":"10.1007/s00247-024-06127-9","url":null,"abstract":"<p><strong>Background: </strong>Blunt abdominal trauma (BAT) is a significant contributor to pediatric mortality, often causing liver and spleen injuries. Contrast-enhanced computed tomography (CT), the gold standard for diagnosing solid organ injury, poses radiation risks to children. Contrast-enhanced ultrasound (CEUS) may be a promising alternative imaging modality.</p><p><strong>Objectives: </strong>To evaluate the diagnostic utility of CEUS for detecting solid organ injuries following BAT in the pediatric population.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted through a thorough literature search in PubMed, Scopus, Web of Science, and Embase databases up to October 1, 2023. Diagnostic accuracy metrics were aggregated using a bivariate model, and subgroup meta-analysis compared CEUS accuracy across various organs.</p><p><strong>Results: </strong>Meta-analysis from four studies, including 364 pediatric patients, revealed a pooled sensitivity of 88.5% (95%CI 82.5-92.6%) and specificity of 98.5% (95%CI 94.9-99.6%), with an area under the curve of 96% (95%CI 88 - 99%). Splenic injuries showed higher sensitivity than liver injuries (P-value < 0.01), while kidney assessments demonstrated higher specificity (P-value < 0.05).</p><p><strong>Conclusion: </strong>This study highlights the diagnostic potential of CEUS for pediatric solid organ injuries caused by BAT. Further large-scale studies are needed due to the limited number and sample size of the included studies.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"226-241"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818806","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":"Commentary: Comparing magnetic resonance enterography and endoscopy findings to the motility of magnetic resonance imaging in pediatric Crohn's disease.","authors":"Sebastian Gallo-Bernal, Valeria Pena-Trujillo, Michael S Gee","doi":"10.1007/s00247-025-06171-z","DOIUrl":"https://doi.org/10.1007/s00247-025-06171-z","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075285","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":"RADHawk-an AI-based knowledge recommender to support precision education, improve reporting productivity, and reduce cognitive load.","authors":"Julian Lopez-Rippe, Manasa Reddy, Maria Camila Velez-Florez, Raisa Amiruddin, Wondwossen Lerebo, Ami Gokli, Michael Francavilla, Janet Reid","doi":"10.1007/s00247-024-06116-y","DOIUrl":"10.1007/s00247-024-06116-y","url":null,"abstract":"<p><strong>Background: </strong>Using artificial intelligence (AI) to augment knowledge is key to establishing precision education in modern radiology training. Our department has developed a novel AI-derived knowledge recommender, the first reported precision education program in radiology, RADHawk (RH), that augments the training of radiology residents and fellows by pushing personalized and relevant educational content in real-time and in context with the case being interpreted.</p><p><strong>Purpose: </strong>To assess the impact on trainees of an AI-based knowledge recommender compared to traditional knowledge sourcing for radiology reporting through reporting time, quality, cognitive load, and learning experiences.</p><p><strong>Materials and methods: </strong>A mixed methods prospective study allocated trainees to intervention and control groups, working with and without access to RH, respectively. Validated questionnaires and observed and graded simulated picture archiving and communication system (PACS)-based reporting at the start and end of a month's rotation assessed technology acceptance, case report quality, case report time and sourcing time, cognitive load, and attitudes toward modified learning strategies. Non-parametric regression analyses and Mann-Whitney tests were used to compare outcomes between groups, with significance set at P<0.05.</p><p><strong>Results: </strong>The intervention group (n=28) demonstrated a statistically significant reduction in the case report time by -162 s per case (95%CI -275.76 s to -52.40 s) (P-value = 0.002) and an increase of 14% (95%CI 8.1-19.8%) (P-value <0.001) in accuracy scores compared to the control group (n=29) at the end of the rotation. The intervention group also showed lower levels of mental demand (P=0.030) and experienced less effort (P=0.030) and frustration (P=0.030) while reporting. Additionally, >78% of the intervention group gave positive ratings on RH's effectiveness, increase in productivity, job usefulness, and ease of use. Eighty-nine percent of participants in the intervention group requested access to RH for their next rotation.</p><p><strong>Conclusion: </strong>This study demonstrates that RH, as the first reported AI-derived knowledge recommender for radiology education, significantly reduces reporting time and improves reporting accuracy while reducing overall workload and mental demand for radiology trainees. The high acceptance among trainees suggests its potential for supporting self-directed learning. Further testing of a larger external cohort will support more widespread implementation of RH for precision education.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"259-267"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792199","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":"Pineal germinoma diagnosed by iohexol CT ventriculography.","authors":"Qiang Li, Jinqian Dong, Qiang Yang, Hu Yang, Xiaodong Luo","doi":"10.1007/s00247-024-06120-2","DOIUrl":"10.1007/s00247-024-06120-2","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"359"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801878","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 single 1-min brain MRI scan for generating multiple synthetic image contrasts in awake children from quantitative relaxometry maps.","authors":"Anandh Kilpattu Ramaniharan, Amol Pednekar, Nehal A Parikh, Usha D Nagaraj, Mary Kate Manhard","doi":"10.1007/s00247-024-06113-1","DOIUrl":"10.1007/s00247-024-06113-1","url":null,"abstract":"<p><strong>Background: </strong>Diagnostically adequate contrast and spatial resolution in brain MRI require prolonged scan times, leading to motion artifacts and image degradation in awake children. Rapid multi-parametric techniques can produce diagnostic images in awake children, which could help to avoid the need for sedation.</p><p><strong>Objective: </strong>To evaluate the utility of a rapid echo-planar imaging (EPI)-based multi-inversion spin and gradient echo (MI-SAGE) technique for generating multi-parametric quantitative brain maps and synthetic contrast images in awake pediatric participants.</p><p><strong>Materials and methods: </strong>In this prospective IRB-approved study, awake research participants 3-10 years old were scanned using MI-SAGE, MOLLI, GRASE, mGRE, and T1-, T2-, T2*-, and FLAIR-weighted sequences. The MI-SAGE T1, T2, and T2* maps and synthetic images were estimated offline. The MI-SAGE parametric values were compared to those from conventional mapping sequences including MOLLI, GRASE, and mGRE, with assessments of repeatability and reproducibility. Synthetic MI-SAGE images and conventional weighted images were reviewed by a neuroradiologist and scored using a 5-point Likert scale. Gray-to-white matter contrast ratios (GWRs) were compared between MI-SAGE synthetic and conventional weighted images. The results were analyzed using the Bland-Altman analysis and intra-class correlation coefficient (ICC).</p><p><strong>Results: </strong>A total of 24 healthy participants aged 3 years to 10 years (mean ± SD, 6.5 ± 1.9; 12 males) completed full imaging exams including the 54-s MI-SAGE acquisition and were included in the analysis. The MI-SAGE T1, T2, and T2* had biases of 32%, -4%, and 23% compared to conventional mapping methods using MOLLI, GRASE, and mGRE, respectively, with moderate to very strong correlations (ICC=0.49-0.99). All MI-SAGE maps exhibited strong to very strong repeatability and reproducibility (ICC=0.80 to 0.99). The synthetic MI-SAGE had average Likert scores of 2.1, 2.1, 2.9, and 2.0 for T1-, T2-, T2*-, and FLAIR-weighted images, respectively, while conventional acquisitions had Likert scores of 3.5, 3.6, 4.6, and 3.8 for T1-, T2-, T2*-, and FLAIR-weighted images, respectively. The MI-SAGE synthetic T1w, T2w, T2*w, and FLAIR GWRs had biases of 17%, 3%, 7%, and 1% compared to the GWR of images from conventional T1w, T2w, T2*w, and FLAIR acquisitions respectively.</p><p><strong>Conclusion: </strong>The derived T1, T2, and T2* maps were correlated with conventional mapping methods and showed strong repeatability and reproducibility. While synthetic MI-SAGE images had greater susceptibility artifacts and lower Likert scores than conventional images, the MI-SAGE technique produced synthetic weighted images with contrasts similar to conventional weighted images and achieved a ten-fold reduction in scan time.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"312-323"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847299","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":"Reply to Venkatakrishna SSB.","authors":"Goni Merhav, Mika Shapira Rootman","doi":"10.1007/s00247-024-06119-9","DOIUrl":"10.1007/s00247-024-06119-9","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"363-364"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872363","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}