Pediatric Radiology最新文献

{"title":"Evaluating micro-computed tomography for investigation of the pediatric hyoid-larynx complex.","authors":"Gmm Timmerman, A Van Goethem, D Docter, J Hagoort, Y Dawood, Nhj Lobe, Q D Gunst, Mjb Van Den Hoff, H M De Bakker, R R Gorter, W Jacobs, R R Van Rijn, V Soerdjbalie-Maikoe, B S De Bakker","doi":"10.1007/s00247-025-06364-6","DOIUrl":"https://doi.org/10.1007/s00247-025-06364-6","url":null,"abstract":"<p><strong>Background: </strong>Conventional CT imaging has limitations in detecting subtle fractures or soft tissue hemorrhages of the pediatric hyoid-larynx complex due to its largely unossified, cartilaginous structure, creating a diagnostic gap in forensic investigations.</p><p><strong>Objective: </strong>To explore the feasibility of micro-computed tomography (micro-CT) and diffusible iodine-based contrast-enhanced computed tomography (diceCT) as high-resolution imaging techniques for detailed forensic and developmental assessment of the pediatric hyoid-larynx complex.</p><p><strong>Materials and methods: </strong>Five pediatric hyoid-larynx complex samples were obtained during forensic autopsies. Specimens were excised, fixed in formaldehyde, and scanned using micro-CT. Subsequently, samples were stained with buffered Lugol's solution and rescanned for diceCT. Imaging was performed with voxel sizes between 12-35 µm. Scans were assessed by a trained analyst and two experienced forensic (pediatric) radiologists.</p><p><strong>Results: </strong>All five samples were successfully imaged using micro-CT and diceCT. Ossification increased with age: the youngest sample showed minimal ossification, while the oldest showed ossification of the hyoid lesser horn and thyroid cartilage. Anatomical variants included bilateral triticeal cartilages and ossified stylohyoid ligament fragments. DiceCT enabled detailed soft tissue visualization and revealed hyperdense bundles and ossification centers within the thyroid cartilage. Staining was complete in smaller samples but limited in the largest. No traumatic injuries were detected on imaging or autopsy.</p><p><strong>Conclusion: </strong>Micro-CT and diceCT offer high-resolution visualization of both ossified and soft tissue structures in the pediatric hyoid-larynx complex. These methods overcome limitations of conventional CT, demonstrating strong potential to enhance forensic evaluation of pediatric neck trauma.</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":"144855959","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":"Unsedated cerebrovascular reactivity imaging is well-tolerated in children.","authors":"Alyssa E Smith, Josiah B Lewis, Jingyi Zhang, Igor Dedkov, Heather Roberts, Madison Streb, Michael M Binkley, Amy Mirro, Jerrel Rutlin, Barbra Giourgas, Joshua S Shimony, Melanie E Fields, Kristin P Guilliams","doi":"10.1007/s00247-025-06350-y","DOIUrl":"https://doi.org/10.1007/s00247-025-06350-y","url":null,"abstract":"<p><strong>Background: </strong>Unsedated MRI use in pediatric clinical and research settings is often feasible, but advanced imaging techniques like cerebrovascular reactivity (CVR) may affect tolerability of unsedated MRIs. Exogenous carbon dioxide (CO₂) provides a CVR vasodilatory challenge, but its impact on unsedated children's MRI tolerability is unknown.</p><p><strong>Objective: </strong>We hypothesized that children would tolerate MRI with exogenous CO₂ as well as children undergoing only MRI.</p><p><strong>Materials and methods: </strong>Children with and without sickle cell disease and/or reactive airway disease participated in prospective, single-site unsedated MRI observational studies and completed a post-scan questionnaire. A RespirAct® device delivered CO₂ during the scan for MRI-measured CVR. Head displacement across frames quantified motion. Tolerability was defined as MRI study completion without lasting symptoms or serious adverse events.</p><p><strong>Results: </strong>One-hundred children participated, with a median age of 14.0 years [11.0, 16.3]. Sickle cell disease and/or reactive airway disease was present in 35% (35/100) and 16% (16/100), respectively. CVR sessions occurred in 75 participants, while 25 had MRI only. All children tolerated and completed the scans; 77% (58/75) had usable CVR data. Motion was similar between those with and without CVR (P=0.33). Children undergoing CVR were more likely to report symptoms, mainly shortness of breath (42/75 vs 3/25; P<0.001), compared to MRI only. Eleven children reported mild, temporary symptoms post-CVR scan; all resolved within a few hours. No serious adverse events occurred. Three children (CVR group) reported unwillingness to repeat the scan.</p><p><strong>Conclusion: </strong>Children tolerate MRI with exogenous CO₂ for CVR measurement with mild, predictable transient symptoms.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837287","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":"Mentorship for career development in pediatric radiology: how to give and receive.","authors":"Elizabeth J Snyder, Mariana L Meyers, Maddy Artunduaga","doi":"10.1007/s00247-025-06369-1","DOIUrl":"https://doi.org/10.1007/s00247-025-06369-1","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837286","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 Kambhampati B.","authors":"Swetha S Yatham, Lara Herbert, Angela Rogers","doi":"10.1007/s00247-025-06368-2","DOIUrl":"https://doi.org/10.1007/s00247-025-06368-2","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822193","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":"Neuroimaging spectrum of myelin oligodendrocyte glycoprotein antibody-associated disease with brain involvement: description of various cerebral syndromes.","authors":"Young Hun Choi, Woo Joong Kim, Byung Chan Lim, Il Han Yoo, Yeon Jin Cho, Seunghyun Lee, Jae-Yeon Hwang, Jung-Eun Cheon","doi":"10.1007/s00247-025-06342-y","DOIUrl":"https://doi.org/10.1007/s00247-025-06342-y","url":null,"abstract":"<p><strong>Background: </strong>Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a notable cause of acquired central nervous system inflammatory disorders in children.</p><p><strong>Objective: </strong>This study aimed to characterize the neuroimaging spectrum of pediatric MOGAD with brain involvement.</p><p><strong>Materials and methods: </strong>In this retrospective, single-center study, 55 children diagnosed with MOGAD involving the brain between January 2010 and October 2020 were included. Clinical data and neuroimaging-brain and spinal magnetic resonance imaging (MRI) at presentation-were reviewed. Imaging patterns were categorized into six radiologic phenotypes: acute disseminated encephalomyelitis (ADEM), cerebral cortical encephalitis, aseptic meningitis, tumefactive demyelinating lesion, cerebellitis/brainstem encephalitis, and miscellaneous. Imaging features were further analyzed in the ADEM subgroup.</p><p><strong>Results: </strong>ADEM was the most common phenotype (39 of 55 patients, 71%), though atypical features were frequent, with 62% showing at least one atypical MRI finding. Unlike classic ADEM with large confluent white matter lesions, MOGAD-associated ADEM often showed small (31%) or subcortical (44%) white matter lesions. Spinal lesions typically appeared as longitudinally extensive myelitis with central gray matter involvement. Other phenotypes included cortical encephalitis (three patients), aseptic meningitis (six), tumefactive demyelinating lesions (three), cerebellitis/brainstem encephalitis (two), and two miscellaneous patterns. Non-ADEM phenotypes presented at an older age than ADEM (11.5 years vs. 5.2 years, P < 0.01), with a threshold of 7.6 years.</p><p><strong>Conclusion: </strong>Pediatric MOGAD with brain involvement presents a range of imaging patterns. ADEM is most frequent but often displays atypical features. Non-ADEM phenotypes tend to occur in older children.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817290","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":"Exploring the role of 3D transabdominal pelvic ultrasound: a pictorial review.","authors":"Chelsea S Life, Sarah S Milla, Veronica I Alaniz, Patricia S Huguelet, Jeffrey J Tutman","doi":"10.1007/s00247-025-06354-8","DOIUrl":"https://doi.org/10.1007/s00247-025-06354-8","url":null,"abstract":"<p><p>Transabdominal pelvic ultrasound plays a pivotal role in the evaluation of pediatric gynecologic pathology, such as Müllerian anomalies and intrauterine device (IUD) malposition. The diagnostic value of this examination can be significantly increased by adding three-dimensional (3D) images, which offer true coronal reconstructions and enhance anatomic detail. Increasing the yield of the examination has the potential to spare the patient discomfort, time, and/or cost. This pictorial essay explores the applications of this widely available, but underutilized, tool while providing embryologic context and pathologic background for some of the most consequential diagnoses radiologists must recognize.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817289","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":"Superior vena cava (SVC) stent placement in children and young adults with congenitally normal cardiac and caval anatomy.","authors":"Michael Leshen, Hawkins C Matthew, Jay Shah, Frederic Bertino, Gary Woods, Michael White, Karen Zimowski, Natalia Townsend, Anne Gill","doi":"10.1007/s00247-025-06328-w","DOIUrl":"https://doi.org/10.1007/s00247-025-06328-w","url":null,"abstract":"<p><strong>Background: </strong>Reports of child and young adult superior vena cava (SVC) stent placement, safety, and long-term patency are limited, particularly in children without congenital heart defects (CHDs).</p><p><strong>Objective: </strong>To characterize technical success, safety, and long-term outcomes of SVC stent placement in children and young adults without co-existing congenital heart defects. Additionally, to demonstrate the ability of SVC stent placement to maintain central venous access in patients with difficult access.</p><p><strong>Materials and methods: </strong>Institutional Review Board (IRB) approved retrospective review of children and young adults without CHDs who underwent SVC stent placement between 2014 and 2024 was performed. SVC stenosis/occlusion was determined by pre-procedure imaging (chest computed tomography (CT) or magnetic resonance imaging (MRI)), and confirmed with venography and intravascular ultrasound. Symptomatic patients were defined as patients with facial or neck swelling, bulging neck or chest wall collaterals, and dependence on central venous access with narrowed or occluded central venous pathways.</p><p><strong>Results: </strong>Nineteen patients (n = 11 F, n = 8 M) without CHDs had SVC stents placed. All had SVC stenosis or occlusion secondary to chronic central venous access. Mean age was 16.5 years (3 - 20 years, interquartile range 7.375 years) and mean weight was 50 kg (15.8 - 115.2 kg, interquartile range 32.6 kg). Ten percent (2/19) presented with acute SVC syndrome. In total, 21% (4/19) required sharp recanalization. Twenty-four total stents were placed; 21 (88%) were bare metal and three were covered. One major complication of SVC tearing occurred during sharp recanalization, which led to hemopericardium/cardiac tamponade. This complication was successfully treated with a pericardial drain and deployment of a second stent across the vessel injury. Median patient follow-up time was 15 months (0.5-88 months, interquartile range 53 months). Seventy-four percent (15/19) had imaging follow-up (chest CT or venography) to assess stent patency, with a mean imaging follow-up of 11 months (3 days-86 months, interquartile range 11 months). Three patients required re-intervention(s): two required venoplasty to allow for catheter exchange, and one required venoplasty for recurrent facial and upper extremity swelling. The mean time to re-intervention was 16 months (2-28). There were no complications during repeat interventions. All patients maintained central venous access for the duration of required treatment or throughout the entire study period.</p><p><strong>Conclusion: </strong>SVC stent placement in children and young adults without CHDs has a favorable safety profile and is an effective solution for preserving critical central venous access for necessary therapy in chronically ill children.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804517","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":"Imaging in pediatric blunt thoracic trauma.","authors":"Emily Orscheln, Preet Sandhu, Narendra Shet","doi":"10.1007/s00247-025-06356-6","DOIUrl":"https://doi.org/10.1007/s00247-025-06356-6","url":null,"abstract":"<p><p>Thoracic trauma is an important cause of mortality in pediatric trauma, and most thoracic trauma in pediatrics is blunt trauma. Pediatric patients have important anatomic and physiologic differences from adults that must be considered in the setting of blunt thoracic trauma. Some of the more significant differences are related to chest wall structure, laxity of mediastinal fixation points, and increased sensitivity to ionizing radiation. When imaging pediatric blunt thoracic trauma, a chest radiograph is the initial test of choice. Further imaging is often not needed, especially if the initial chest radiograph is normal, and additional findings on computed tomography (CT) often do not impact management. Factors which have been found to increase the utility of chest CT in pediatric blunt thoracic trauma include age 15 years or older, abnormal chest auscultation, tachycardia, chest pain, abnormal chest radiograph - especially mediastinal contour abnormality - and severe mechanism. Common injuries in pediatric blunt thoracic trauma include pulmonary contusion, pulmonary laceration, pneumothorax, hemothorax, and rib fractures. Rare but important injuries include cardiac and great vessel injuries, tracheobronchial injuries, esophageal injuries, and diaphragmatic injuries.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804516","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":"Biometry and volumetry in multi-centric fetal brain magnetic resonance imaging: assessing the bias of super-resolution reconstruction.","authors":"Thomas Sanchez, Angeline Mihailov, Mériam Koob, Nadine Girard, Aurélie Manchon, Ignacio Valenzuela, Marta Gómez-Chiari, Gerard Martí Juan, Alexandre Pron, Elisenda Eixarch, Gemma Piella, Miguel Angel Gonzalez Ballester, Oscar Camara, Vincent Dunet, Guillaume Auzias, Meritxell Bach Cuadra","doi":"10.1007/s00247-025-06347-7","DOIUrl":"https://doi.org/10.1007/s00247-025-06347-7","url":null,"abstract":"<p><strong>Background: </strong>Fetal brain MRI is increasingly used to complement ultrasound imaging. Images are processed using complex super-resolution reconstruction pipelines, which may bias biometric and volumetric measurements.</p><p><strong>Objective: </strong>To assess the consistency of 2-dimensional (D) biometric and 3-D volumetric measurements across three hospitals using three widely used super-resolution reconstruction pipelines.</p><p><strong>Materials and methods: </strong>This retrospective multi-centric study used T2-weighted fetal brain MRI scans acquired at three hospitals between 2009 and 2023. MRIs from each subject were reconstructed with each super-resolution reconstruction method, and biometric measurements were performed by four experts. Automated 3-D volumetry was performed using a state-of-the-art segmentation method. A qualitative evaluation assessed the clinicians' likelihood of using super-resolution reconstructed volumes in their practice.</p><p><strong>Results: </strong>Eighty-four healthy subjects were included. Biometric measurements revealed statistically significant changes that consistently remained below voxel width (0.8 mm; P<0.001). Automated 3-D volumetry revealed small systematic effects (<2.8%; P<0.001). The qualitative evaluation showed systematic differences between super-resolution reconstruction methods for the perception of white matter intensity (P=0.02) and sharpness of the image (P=0.01).</p><p><strong>Conclusion: </strong>Variations in 2-D and 3-D quantitative measurements did not show any large systematic bias when using different super-resolution reconstruction methods for clinical radiological assessment across centers, scanners, and raters.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799851","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":"Idiopathic scrotal hematoma in newborns: a case report and literature review.","authors":"Carlotta Plessi, Grazia Spampinato, Enrica Caponcelli, Viviana Durante, Michelina Ciliberti, Katia Rossi, Pier Luca Ceccarelli","doi":"10.1007/s00247-025-06357-5","DOIUrl":"https://doi.org/10.1007/s00247-025-06357-5","url":null,"abstract":"<p><p>Neonatal acute scrotum is an uncommon condition, with testicular torsion being the most critical differential diagnosis. Idiopathic scrotal hematoma is a rare entity characterized by scrotal swelling and discoloration, with preserved testicular perfusion. Differentiating idiopathic scrotal hematoma from testicular torsion is challenging but essential to avoid unnecessary surgery. We report a case of a newborn who presented with scrotal swelling and discoloration at 72 h of life. Doppler ultrasound revealed preserved testicular blood flow, and abdominal ultrasound excluded intra-abdominal pathology. The patient was diagnosed with idiopathic scrotal hematoma and managed conservatively. A review of 16 cases of neonatal idiopathic scrotal hematoma highlights its diagnostic challenges and the potential for misdiagnosis. While early reports emphasized surgical exploration, advances in imaging, particularly Doppler ultrasound, now allow for non-invasive diagnosis and conservative management.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799852","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}