Pediatric Radiology最新文献

{"title":"Risk of acute kidney injury following intravenous iodinated contrast exposure among pediatric population: a narrative review.","authors":"Nawaf Salah Ayad Mohamed, Faisal Waleed Abdullah Alkharji, Majd Fuad Ghareeb, Aljoharah Aljabr","doi":"10.1007/s00247-025-06380-6","DOIUrl":"https://doi.org/10.1007/s00247-025-06380-6","url":null,"abstract":"<p><p>Contrast-induced acute kidney injury is a significant concern in pediatric populations following the administration of intravenous iodinated contrast media. This narrative review aims to systematically evaluate the incidence, risk factors, and diagnostic criteria associated with contrast-induced acute kidney injury in children, addressing the variability in reported rates and the implications for clinical practice. The rationale for this review stems from the need to clarify the relationship between iodinated contrast media exposure and acute kidney injury, particularly in high-risk pediatric patients, as existing literature presents inconsistent findings. A comprehensive literature search was conducted using PubMed, Scientific Direct, and Google Scholar databases, focusing on studies published between 2020 and 2025 that addressed contrast-induced acute kidney injury in children. The review identified key messages, including that contrast-induced acute kidney injury incidence ranges from 1.4-35%, influenced by factors such as chronic kidney disease, estimated glomerular filtration rates, age, and gender. The findings emphasize the need for standardized diagnostic criteria and protocols to improve the assessment and management of contrast-induced acute kidney injury in children. Additionally, there is a gap in robust randomized controlled trials, highlighting the necessity for future multicenter studies to explore novel biomarkers for early detection and effective preventive strategies. This review advocates for a balanced approach to using iodinated contrast media in pediatric patients while aiming to prevent unnecessary exclusions from vital diagnostic procedures.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963983","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 quantitative analysis of placenta and fetal brain in small-for-gestational-age pregnancies: a feasibility study.","authors":"Bingqing Xia, Ling Jiang, Zhaoxia Qian, Feifei Qu, Jiangjie Wu, Hongjiang Wei, Taotao Sun","doi":"10.1007/s00247-025-06373-5","DOIUrl":"https://doi.org/10.1007/s00247-025-06373-5","url":null,"abstract":"<p><strong>Background: </strong>Small-for-gestational-age (SGA) pregnancy is often associated with impaired placental function, which would lead to neurodevelopmental deficits.</p><p><strong>Objective: </strong>To utilize the geometric properties of cortical development for quantitative analysis of the relationship between impaired placental function and fetal brain development in pregnancies with SGA fetuses.</p><p><strong>Materials and methods: </strong>This retrospective study included 41 pregnant women with appropriate gestational age (GA) (range, 23-38.6 weeks) and 26 pregnant women with SGA pregnancies (range, 23.3-36.3 weeks). After the exclusion of 25 participants with normal fetal brain data but noticeable motor artifacts, 29 fetal brains from the normal group and 16 fetal brains from the SGA group were included in this analysis. Examinations were conducted using a 1.5-T magnetic resonance imaging (MRI) system. Fetal brain cortical thickness and regional volume were calculated for each participant according to a standardized anatomical atlas. Placental intravoxel incoherent motion (IVIM) imaging and T2* mapping were performed. IVIM parameters (perfusion fraction (f), perfusion diffusivity coefficient (D*), and tissue diffusivity (D)) and T2* parameters were subsequently analyzed.</p><p><strong>Results: </strong>T2* and f values were significantly lower in SGA pregnancies than in the control group (P < 0.05), indicating impaired placental growth. Nine regions of cortical thickness exhibited significant differences (P<0.05) between the normal and the SGA groups. In the control group, 30 of 86 brain regions (34.88%) exhibited moderate or strong correlations between cortical thickness and T2* values. Among these regions, 19 were in the right hemisphere, whereas 11 were in the left hemisphere.</p><p><strong>Conclusion: </strong>Quantitative assessment of changes in placental function and fetal brain cortical thickness is feasible and may provide valuable pathophysiological insights. Cortical thickness variations may act as potential biomarkers, assisting clinicians in early identification of SGA fetuses at risk of neurodevelopmental challenges.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964037","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":"Intra- and inter-observer reliability and repeatability of the metatarsus adductus angle in childhood: A concordance study.","authors":"Eduardo Pérez-Boal, Carlos Martin-Villa, Ricardo Becerro-de-Bengoa-Vallejo, Marta Elena Losa-Iglesias, Bibiana Trevissón-Redondo, Daniel López-López, César Calvo-Lobo, David Rodríguez-Sanz, Eva María Martínez-Jiménez, Israel Casado-Hernández","doi":"10.1007/s00247-025-06375-3","DOIUrl":"https://doi.org/10.1007/s00247-025-06375-3","url":null,"abstract":"<p><strong>Background: </strong>Metatarsus adductus is a relatively common congenital foot deformity often unrecognized at birth. There is adduction of the metatarsals, supination of the subtalar joint, and plantar flexion of the first ray.</p><p><strong>Objective: </strong>The objective of this study was to utilize the most commonly used methods for assessing metatarsus adductus deformity in children and to identify the measurements with the least intra- and inter-observer variability.</p><p><strong>Materials and methods: </strong>All consecutive patients between 2 and 9 years of age with metatarsus adductus by roentgenographic evaluation on weight-bearing dorsoplantar images were included in this cross-sectional study. Measurements included 32 radiographs, 18 feet from 14 girls with a mean age of 3.73 ± 2.53 years, and 14 feet corresponding to 11 boys with a mean age of 5.21 ± 2.15 years. We identified and assessed all radiographic measurements to evaluate the metatarsus adductus with the different measurements commonly used today, including the Berg, Kilmartin, Laaveg & Ponseti, rearfoot, Root, and Simons' angles.</p><p><strong>Results: </strong>The reliability of the variables measured in 32 weight-bearing dorsoplantar foot radiographs showed excellent reliability ranging in Laaveg-Ponseti and rearfoot angles with low standard error of measurement (SEM), coefficient of variation (CV), and minimum detectable change (MDC) with intraclass correlation coefficient (ICC) higher than 0.990. Kilmartin, Root, and Simons' angles showed good intra- and inter-observer reliability, with ICC values greater than 0.900; however, they also exhibited systematic differences between sessions or between observers (P < 0.05), or a high MDC value, which may limit their reproducibility.</p><p><strong>Conclusion: </strong>Based on the results obtained in this study from the different measurements performed, the rearfoot measurement and the method proposed by Laaveg and Ponseti can be considered the most reliable, as they showed the highest intra- and inter-observer reliability.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964021","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/s00247-025-06384-2","DOIUrl":"https://doi.org/10.1007/s00247-025-06384-2","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963952","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":"Tulip sign in prenatal hypospadias diagnosis.","authors":"Yue Xi, Huiying Wu","doi":"10.1007/s00247-025-06377-1","DOIUrl":"10.1007/s00247-025-06377-1","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144874482","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":"Prenatal diagnosis conventional/four-dimensional direct volume rendering fetal echocardiography pregnancy and postnatal outcomes of isolated anomalous course of left brachiocephalic vein.","authors":"Balaganesh Karmegaraj, Sowmya Vijayakumar","doi":"10.1007/s00247-025-06367-3","DOIUrl":"https://doi.org/10.1007/s00247-025-06367-3","url":null,"abstract":"<p><strong>Background: </strong>Advances in fetal echocardiography, including conventional 2-dimensional (D) and 3-D/4-D imaging techniques, have improved our understanding of upper mediastinal vessels.</p><p><strong>Objective: </strong>To study the prenatal imaging characteristics, pregnancy, and postnatal outcomes in fetuses with an isolated anomalous course of the left brachiocephalic vein.</p><p><strong>Materials and methods: </strong>This retrospective study, conducted between October 2019 and July 2024, examined fetuses with an isolated anomalous course of the left brachiocephalic vein. These cases underwent conventional 2-D and 3-D/4-D spatiotemporal image correlation echocardiography at Sowmi Pediatric Heart Centre, Tirunelveli, India. The inclusion criteria encompassed all fetuses with an isolated anomalous course of the left brachiocephalic vein, whereas those with associated congenital heart defects or missing postnatal follow-up were excluded from the analysis.</p><p><strong>Results: </strong>A total of 2,083 fetal echocardiograms were performed during the study period. In total, 331 fetal cardiac abnormalities were detected. Twelve fetuses with isolated anomalous course of left brachiocephalic vein were included in the study. Intrathymic left brachiocephalic vein was observed in nine fetuses, extrathymic left brachiocephalic vein in two fetuses, and retroaortic left brachiocephalic vein in one fetus. Quadruple marker screening in five cases yielded normal results. Invasive genetic testing performed in the case with retroaortic left brachiocephalic vein showed normal findings. Postnatally, no dysmorphism was observed in any fetus. All fetuses were delivered at term, had an uneventful postnatal period, underwent at least 3 months of follow-up, and were reassured.</p><p><strong>Conclusion: </strong>Though the indication for referral for this fetal extracardiac anomaly was to rule out critical congenital heart disease, proper prenatal imaging of this benign finding will avoid unnecessary confusion, in utero referral to tertiary pediatric heart center for delivery and invasive genetic tests.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144874481","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 systematic review of radiation dose to the eye lens from pediatric brain computed tomography scans.","authors":"Amanda Alison Perdomo, Jake Cameron Forster, Mohamed Khaldoun Badawy","doi":"10.1007/s00247-025-06371-7","DOIUrl":"https://doi.org/10.1007/s00247-025-06371-7","url":null,"abstract":"<p><strong>Background: </strong>With the increasing use of pediatric brain computed tomography (CT) and the International Commission on Radiological Protection's revised threshold for radiation-induced lens opacities, concerns have grown regarding cumulative radiation exposure to the eye lens.</p><p><strong>Objective: </strong>This review examines the magnitude of lens doses reported in pediatric brain CT and the methodologies used to estimate these doses.</p><p><strong>Methods: </strong>A systematic literature search of MedLine, Embase, and PubMed (2012-2024) identified 18 eligible studies, including direct patient measurements, phantom-based experiments, and computational modeling.</p><p><strong>Results: </strong>Reported lens doses varied widely across studies. Software-based tools generally estimate higher doses than those measured directly on patients or phantoms. Multiple dose-reduction strategies such as gantry tilting, organ-based tube current modulation, and protocol optimization were effective in significantly lowering lens exposure without compromising diagnostic quality.</p><p><strong>Conclusion: </strong>In all cases, individual scan doses remain below the cataractogenic threshold. However, children undergoing repeated imaging may exceed this limit over time. Cumulative lens dose tracking and routine implementation of orbit-sparing techniques are recommended to reduce long-term radiation risk in vulnerable pediatric populations.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855957","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 MRI findings in conjoined twin pregnancies.","authors":"Julie E Walcutt, Beth M Kline-Fath, Rama S Ayyala, Foong-Yen Lim, Usha D Nagaraj","doi":"10.1007/s00247-025-06323-1","DOIUrl":"https://doi.org/10.1007/s00247-025-06323-1","url":null,"abstract":"<p><p>Conjoined twins are a rare and complex anomaly of monozygotic twin gestations, in which there is joining of the bodies of two individuals. Prenatal imaging, including fetal MRI, plays a crucial role in prognostication and planning for these twins' families and multi-disciplinary medical teams. The ability of fetal MRI to provide large field-of-view imaging is well-suited to delineate the complicated shared and individual anatomy of these twins. In this review, we describe an approach to the fetal MRI of conjoined twins and its limitations, illustrate the fetal MRI findings of the conjoined twin morphological variants, and discuss common superimposed anomalies. The anatomic features most predictive of these twins' chances for survival and separation are also summarized.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855960","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 rare pediatric case of Li-Fraumeni syndrome presenting with virilization symptoms and dual primary malignancies on magnetic resonance imaging and [¹⁸F]-fluorodeoxyglucose positron emission tomography/computed tomography.","authors":"Jiawen Chen, Wei Ouyang","doi":"10.1007/s00247-025-06340-0","DOIUrl":"https://doi.org/10.1007/s00247-025-06340-0","url":null,"abstract":"<p><p>This case report describes a 19-month-old boy presenting with macropenis, increased stature, and deep voice, who was diagnosed with concurrent choroid plexus carcinoma in the right lateral ventricle and left adrenocortical carcinoma. Subsequent germline testing revealed pathogenic TP53 mutations, confirming a diagnosis of Li-Fraumeni syndrome. Li-Fraumeni syndrome with primary manifestations of macropenis and accelerated linear growth has rarely been documented in the medical literature. This case highlights the critical importance of implementing whole-body imaging modalities in pediatric patients with growth-developmental abnormalities, particularly those suggestive of Li-Fraumeni syndrome, to guide therapeutic decision-making and follow-up monitoring.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855956","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":"Early radiologic tumour volume response in non-metastatic rhabdomyosarcoma is not predictive for survival.","authors":"Isabelle S A de Vries, Carlo Morosi, Gianni Bisogno, Veronique Minard-Colin, Beatrice Coppadoro, Ilaria Zanetti, Andrea Ferrari, Daniel Orbach, Salma Moalla, Myriam Ben-Arush, Christine Devalck, Roelof van Ewijk, Kieran McHugh, Meriel Jenney, Julia Chisholm, Gabriela Guillen, Henry Mandeville, Johannes H M Merks, Rick R Van Rijn","doi":"10.1007/s00247-025-06359-3","DOIUrl":"https://doi.org/10.1007/s00247-025-06359-3","url":null,"abstract":"<p><strong>Background: </strong>There is an urgent need for early radiological markers predicting survival in paediatric rhabdomyosarcoma patients.</p><p><strong>Objective: </strong>To analyse the predictive value of early radiological tumour volume response to chemotherapy in non-metastatic rhabdomyosarcoma patients.</p><p><strong>Methods: </strong>The European paediatric Soft tissue sarcoma Study Group (EpSSG) RMS 2005 study prospectively included non-metastatic rhabdomyosarcoma patients. Patients with Intergroup Rhabdomyosarcoma Studies (IRS) postsurgical Group III (i.e. measurable disease) at diagnosis, with three tumour diameters available at diagnosis and following three cycles of chemotherapy, were included. Tumour response was categorized as complete response, partial response, minor partial response, stable disease, or progressive disease. Patients with progressive disease were excluded from analyses. Failure-free survival and overall survival were estimated with Kaplan-Meier using a landmark analysis. Prognostic factors were assessed using Cox proportional hazards analyses.</p><p><strong>Results: </strong>Of 1,674 patients aged < 18 years at diagnosis included in the EpSSG RMS 2005 study, 613 patients (median age 4.2 years, interquartile range 2.2-8.0, 346 males) were eligible for analysis. After three cycles of chemotherapy, 48 patients reached complete response, 371 partial response, 139 minor partial response, 48 stable disease, and seven patients progressive disease. Univariate Cox proportional hazards model showed no significant difference between response groups for failure-free survival or overall survival. In multivariate Cox regression analysis, tumour volume response was not an independent prognostic factor for failure-free survival or overall survival.</p><p><strong>Conclusion: </strong>Early radiological tumour volume response after the third cycle of neoadjuvant chemotherapy, with exclusion of progressive disease, does not predict survival in paediatric rhabdomyosarcoma patients.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855958","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}