Pediatric Radiology最新文献

{"title":"Retrospective observational study of the magnetic resonance imaging features of MPV17-related mitochondrial DNA depletion syndrome.","authors":"Suzanne O'Hagan, Surita Meldau, Penelope Rose, Magriet Van Niekerk, Christelle Ackermann, Gillian Riordan, Ronald Van Toorn","doi":"10.1007/s00247-025-06341-z","DOIUrl":"https://doi.org/10.1007/s00247-025-06341-z","url":null,"abstract":"<p><strong>Background: </strong>MPV17-related mitochondrial deoxyribonucleic acid (DNA) maintenance defects present in most affected individuals as an early-onset encephalohepatopathic disease. Diagnosis requires comprehensive molecular genetic testing, which is often not available in resource-limited settings. Therefore, the role of imaging as a diagnostic tool necessitates further exploration. Herein, we present the largest known cohort of patients with genetically confirmed MPV17-related mitochondrial DNA depletion syndrome, highlighting in detail the neuroimaging findings.</p><p><strong>Objective: </strong>To establish novel features on magnetic resonance imaging (MRI) that characterise MPV17-related mitochondrial DNA depletion syndrome, in order to provide a non-invasive, accessible, and reproducible biomarker inquiry.</p><p><strong>Materials and methods: </strong>Retrospective, descriptive study based at a large tertiary level hospital. Eight patients with MPV17-related mitochondrial DNA depletion syndrome who had undergone brain MRI were identified between 2015 and 2023. Neuroimaging findings were captured and described in detail. Two board-certified radiologists with experience in paediatric neuroradiology reviewed all images by consensus.</p><p><strong>Results: </strong>All patients were homozygous for the MPV17: c.106C>T variant. Age at brain MRI ranged from 11 days to 8 months. Seven out of the eight patients showed signal abnormalities in the reticulospinal tracts and/or reticular formation. Other neuroimaging findings included leukoencephalopathy, injury to extra-reticular white matter tracts and frequent basal ganglia involvement. Newly identified areas of involvement include the perirolandic cortices, hippocampi, optic pathways and olfactory nerves.</p><p><strong>Conclusion: </strong>Lesions in the reticular formation and reticulospinal tracts on brain MRI in a neonate or infant with hepatic dysfunction may represent a distinctive, albeit not specific, feature of MPV17-related mitochondrial DNA depletion syndrome.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795019","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":"Proximal medial tibial metaphyseal bump-a normal variant.","authors":"Bryan Zuniga, Nicholas Lopez, Kirsten Simonton, Jonathan D Samet","doi":"10.1007/s00247-025-06361-9","DOIUrl":"https://doi.org/10.1007/s00247-025-06361-9","url":null,"abstract":"<p><strong>Background: </strong>Skeletal abnormalities are important to recognize in the workup of physical child abuse. Normal variants can simulate child abuse and cause incorrect diagnosis and management. An osseous protuberance of the proximal medial tibial metaphysis, \"the tibial bump,\" is a normal variant that is important to recognize.</p><p><strong>Objective: </strong>To determine the prevalence of a tibial bump in infants undergoing a skeletal survey for a child abuse evaluation.</p><p><strong>Materials and methods: </strong>A retrospective study of initial and follow-up child abuse skeletal surveys at a tertiary center was conducted to assess for the presence of a tibial bump on the proximal medial tibial metaphysis. The presence or absence of fracture healing changes around the tibial bump was recorded.</p><p><strong>Results: </strong>Twenty of two hundred sixty cases showed a tibial bump on the initial skeletal survey, estimating a prevalence of 7.7%. Fourteen of these twenty cases (70%) demonstrated a persistent tibial bump unchanged in appearance on the follow-up skeletal survey. None of the tibial bumps demonstrated findings of a healing fracture on the initial or follow-up skeletal survey. In cases with a tibial bump present, 10 (50%) were bilateral and 10 were unilateral (50%). The mean (median) age of a child with a tibial bump was 3.5 (2.9) months with a range from 1 to 8 months, and there was a statistically significant association between age and the presence of a bump, supporting that this is a finding of infancy (P = 0.04).</p><p><strong>Conclusion: </strong>A tibial bump on the proximal medial tibial metaphysis was a relatively common finding in infants undergoing workup for child abuse and not radiographically consistent with a fracture. It is a normal variant and should not be confused with a traumatic finding.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794932","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 quality improvement project to reduce magnetic resonance imaging sedation in children.","authors":"Juan Boriosi, Christina Bryndzia, Michael Lasarev, Justin Brucker, Susan Rebsamen, Teresa Chapman, Brianna Peterson, Megan Peters","doi":"10.1007/s00247-025-06293-4","DOIUrl":"https://doi.org/10.1007/s00247-025-06293-4","url":null,"abstract":"<p><strong>Background: </strong>Our institution decided to implement an awake MRI scanning quality improvement project using audiovisual distraction (AVD) technology.</p><p><strong>Objective: </strong>To reduce the utilization of minimal/moderate sedation by at least 20% in children 4 to 18 years, while maintaining comparable diagnostic quality and adhering to allotted exam times, through the implementation of an awake MRI program.</p><p><strong>Materials and methods: </strong>This project was conducted at a pediatric sedation clinic between October 2021 and January 2024. We included patients 4 to 18 years of age, scheduled for an MRI at the pediatric hospital, and eligible for either minimal/moderate sedation or AVD. The outcome measure was the percentage of patients referred to our sedation clinic who completed an MRI with AVD and without sedation, analyzed on a statistical process control (SPC) P-Chart. Process measures were the number of children eligible for AVD per month, analyzed on an SPC C-Chart. Balance measures were the number of studies that exceeded allotted exam time or were non-diagnostic.</p><p><strong>Results: </strong>Of 734 MRI referrals aged 4 to 18 years, 320 patients met inclusion criteria. Two hundred twenty-eight (71.3%) received minimal/moderate sedation (mean age [SD] 9.7 years [± 3.0]) and 92 (28.8%) underwent AVD (mean age 10.0 years [± 2.7]). The average monthly decrease in minimal/moderate sedation use was 28.8 percentage points. The average number of children considered eligible for AVD increased by special cause variation from 3.8 to 7 patients per month. All 92 MRI referrals triaged to AVD completed their MRI successfully without sedation; all studies were diagnostic, and 96% of studies were within the allotted exam time.</p><p><strong>Conclusion: </strong>We implemented an awake MRI program with AVD that decreased monthly sedation needs by 28.8 percentage points while maintaining a high rate of diagnostic studies and no MRI delays.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789669","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":"Bipartite patella revisited: the not so asymptomatic accessory ossicle.","authors":"Samuel X Ramirez, Stuart D Ferrell, Indranil V Kushare, J Herman Kan","doi":"10.1007/s00247-025-06344-w","DOIUrl":"https://doi.org/10.1007/s00247-025-06344-w","url":null,"abstract":"<p><strong>Background: </strong>The bipartite patella is a controversial variant, with definitions spanning from normal to stigmata related to patellofemoral dysplasia.</p><p><strong>Objective: </strong>The purpose of this study is to quantitatively determine if a bipartite patella is in the spectrum of normal versus forme fruste of underlying patellofemoral dysplasia in children using magnetic resonance imaging (MRI) data. A secondary purpose is to assess the MRI findings of the symptomatic bipartite and its implications for patient care.</p><p><strong>Materials and methods: </strong>A retrospective review of bipartite patellae imaged on knee MRI from 1/2010-3/2024 was conducted. Matched cohorts of control and patellofemoral dysplasia knees were created. Trochlear depth, sulcus angle, CDI, TT-TG, lateral patellar tilt and subluxation, lateral trochlear inclination, and clinical management were evaluated, comparing the bipartite knee MRIs with control and dysplastic knees. Chi-square and Mann-Whitney U tests were used, with P-values for significance set to 0.05.</p><p><strong>Results: </strong>From 46 patients, 47 bipartite patellae (mean age, 13.3 ± 3.1) were included in the study. In total, 77% (36/47) were male (mean age, 13.6 ± 3.0) while 23% (11/47) were female (mean age, 12.2 ± 3.2). No significant difference in quantitative measurements existed between bipartite patellae and control knees. Significant differences existed for all quantitative measurements defining trochlear dysplasia between bipartite and patellofemoral dysplasia cohorts (P<0.001 for all measurements). Bipartite ossicle edema (39/47, 83%) and Hoffa fat pad edema (17/47, 36%) were frequently present. Six of 47(13%) required surgery for pain management- all had ossicle edema present.</p><p><strong>Conclusion: </strong>The presence of a bipartite patella does not appear to be associated with underlying patellofemoral dysplasia. The bipartite patella can frequently be a source of a child's pain and should not be treated as a normal ossification variant.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789635","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":"Frequency and outcomes of gastrojejunostomy tube replacement in children - a single-centre experience: reply to Yatham et al.","authors":"Bhaskar Kambhampati, Rachana Mehta, Ranjana Sah","doi":"10.1007/s00247-025-06355-7","DOIUrl":"10.1007/s00247-025-06355-7","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784955","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":"What are the computed tomography patterns of head injury following low-velocity accidental head trauma in infants?","authors":"Valeria Della Valle, Saskia Vande Perre, Nathalie de Suremain, Solène Loschi, Catherine Adamsbaum, Catherine Garel","doi":"10.1007/s00247-025-06348-6","DOIUrl":"https://doi.org/10.1007/s00247-025-06348-6","url":null,"abstract":"<p><strong>Background: </strong>Differentiating accidental head trauma and abusive head trauma (AHT) may be challenging in infants.</p><p><strong>Objective: </strong>To describe computed tomography (CT) scan findings following accidental low-velocity trauma in infants, focusing on features considered to be highly suggestive of AHT, such as rupture of bridging veins.</p><p><strong>Materials and methods: </strong>A single-center, retrospective study (2014-2022) was performed in infants aged 1 month to 12 months.</p><p><strong>Inclusion criteria: </strong>(i) any kind of minor head trauma leading to an Emergency Department visit (fall from a height of less than 2 m, direct head impact, low-velocity road accident (below 15 km/h); (ii) available clinical data and head CT scan.</p><p><strong>Results: </strong>Three hundred and six infants were included (mean age 5 months 14 days, 56.5% male). Fractures were observed in 89 patients (71 simple linear fractures). Intracranial hemorrhage was observed in 34 patients: simple post-traumatic focal extra-axial hemorrhage in 26 patients and more complex hemorrhage on CT and magnetic resonance imaging in eight patients, including three with evidence of bridging vein rupture. Among these cases, the child protection team expressed concern that two patients might have experienced AHT, while the third patient had a condylar fracture and it remains unclear whether the injury was the result of AHT or an accidental fall. A significant link was found between intracranial hemorrhage and fractures (P-value < 0.001), scalp swelling (P-value < 0.001), or clots located at the vertex (P-value < 0.001) and between fractures and scalp swelling (P-value < 0.001), the trauma mechanism (P-value < 0.001), neurological symptoms (P-value = 0.03), and intracranial hemorrhage (P-value < 0.001).</p><p><strong>Conclusion: </strong>The main CT scan features following minor accidental trauma in infants are simple skull fractures and scalp swelling. Diffuse hemorrhage with rupture of bridging veins is exceptional in this context.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775974","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 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":"Costochondral junction variations in children younger than 2 years.","authors":"Boaz Karmazyn, Matthew M Jones, Lisa R Delaney, Ralph A Hicks, Ann E Freshour, Megan B Marine, Shannon L Thompson, S Gregory Jennings, George J Eckert, Monica M Forbes-Amrhein","doi":"10.1007/s00247-025-06316-0","DOIUrl":"10.1007/s00247-025-06316-0","url":null,"abstract":"<p><strong>Background: </strong>Costochondral junction fractures are considered specific for child abuse and typically heal with a deformed costochondral junction.</p><p><strong>Objective: </strong>To evaluate the types, location, and incidence of costochondral junction variations that can mimic fractures.</p><p><strong>Materials and methods: </strong>A 15-year retrospective study was conducted on children under 2 years of age who underwent chest and abdominal computerized tomography (CT) scans for pneumonia, fever, congenital lung disease, pain, or appendicitis. Randomized selection included 120 chest and 120 abdominal CT scans. Demographic and clinical information was obtained from medical record reviews. Two pediatric radiologists independently reviewed the studies and indicated the presence and location of costochondral junction variation patterns (spurs), and fissure, horizontal lucency, corner, or bucket handle as identified on two consecutive slices on axial views. Disagreements were resolved by a third radiologist. We excluded patients with underlying medical conditions that could affect the skeleton and studies with motion artifacts. A t-test was used to evaluate the relationships between age, CT slice thickness, and the diagnosis of costochondral junction variations. Kappa statistics were used to evaluate agreement.</p><p><strong>Results: </strong>A total of 123 children were excluded due to motion artifacts (n = 30), trauma (n = 31), being evaluated for child abuse (n = 3), slice thickness of 5 mm (n = 1), and underlying medical conditions (n = 58). The final group included 117 children (73 males and 44 females) with an average age of 1 year; 64 had chest and 53 abdominal CT scans. Agreement was fair (kappa = 0.29) at the patient level and poor at the rib level (kappa = 0-0.64). The final number of variations, after resolving disagreements with a third radiologist, was 46 of costochondral junction variations in 19 children (16.2%, 19/117); all were costochondral junction spurs at the levels of the second to eighth ribs. Costochondral junction variations were significantly more common in younger children (average 0.7 ± 0.6 years vs. 1.1 ± 0.6 years, P = 0.024) and when there was thinner CT slice thickness (average 1.6 ± 1.4 mm vs. 2.5 ± 1.5 mm, P = 0.041).</p><p><strong>Conclusion: </strong>Costochondral junction variations were identified in 16.2% of children under 2 years of age, and some may mimic healing costochondral junction fractures. There was only fair agreement between radiologists.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"1883-1890"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659780","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":"Cinematic rendering of gastrointestinal foreign body in a child.","authors":"Lulin Bi, Tianfang Tong","doi":"10.1007/s00247-025-06262-x","DOIUrl":"10.1007/s00247-025-06262-x","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"1957"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111554","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":"Pulmonary agenesis with tracheal bronchus in a 17-year-old.","authors":"Ahmet Tuğrul Akkuş","doi":"10.1007/s00247-025-06331-1","DOIUrl":"10.1007/s00247-025-06331-1","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"1958"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668083","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}