Pediatric Radiology最新文献

{"title":"Fracture-dislocation of the distal phalangeal epiphysis in a toddler.","authors":"Nicole Blattman, Peter J Strouse, Aparna Joshi","doi":"10.1007/s00247-026-06791-z","DOIUrl":"https://doi.org/10.1007/s00247-026-06791-z","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039917","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":"Multimodality imaging of cerebrospinal fluid shunts: system evaluation and complications.","authors":"Safa Hoodeshenase, Lauren Averill, Tejal Mody, Craig Johnson","doi":"10.1007/s00247-026-06759-z","DOIUrl":"https://doi.org/10.1007/s00247-026-06759-z","url":null,"abstract":"<p><p>Cerebrospinal fluid (CSF) shunts are critical for managing hydrocephalus by diverting excess CSF from the craniospinal axis to absorptive sites. Imaging plays a pivotal role in the assessment of shunt function, early postoperative changes, and a wide array of complications. Understanding the imaging characteristics of both normal postoperative appearances and potential complications with different imaging modalities enhances diagnostic accuracy and enables timely clinical management. This comprehensive review outlines the anatomical and functional aspects of various shunt systems.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031215","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":"International practice patterns in the use of ultrasound as first-line imaging for suspected midgut volvulus in children: a joint society for pediatric radiology-European society of paediatric radiology survey.","authors":"Jeffrey Tutman, Giulia Perucca, Sherwin Chan, Alexander El-Ali, Damjana Kljucevsek, Ione Limantoro, Michael Riccabona, Philippe Petit, HaiThuy N Nguyen, Jonathan Samet","doi":"10.1007/s00247-026-06792-y","DOIUrl":"https://doi.org/10.1007/s00247-026-06792-y","url":null,"abstract":"<p><strong>Background: </strong>Midgut volvulus is a surgical emergency that requires rapid diagnosis to prevent bowel ischemia. Although fluoroscopic upper gastrointestinal examinations have traditionally been used in some countries, ultrasound is gaining acceptance as a potential first-line imaging modality.</p><p><strong>Objective: </strong>To evaluate international practice patterns of first-line ultrasound use for suspected midgut volvulus in children and identify factors influencing adoption.</p><p><strong>Materials and methods: </strong>A voluntary online survey was distributed to members of the Society for Pediatric Radiology and the European Society of Paediatric Radiology between August and September 2025. Survey items addressed institutional use of first-line ultrasound for suspected midgut volvulus, duration of experience, personnel performing examinations, protocol details, and factors influencing adoption. Responses were analyzed by geographic region.</p><p><strong>Results: </strong>Overall, 227 responses representing 179 hospitals across 38 countries were analyzed. First-line ultrasound was used by 78.2% of European hospitals, 28.9% of North American hospitals, and 61.1% of hospitals in other regions. In Europe, the most frequently reported barrier to adoption was radiologist acceptance, whereas in North America the most common barrier was sonographer training and competence. Across all regions, most institutions reported no formal clinical pathway, no standardized reporting template, and no routine administration of oral or nasogastric fluid during the examination. Publication of formal guidelines was the most commonly reported factor that respondents believed would facilitate adoption.</p><p><strong>Conclusion: </strong>Use of ultrasound as first-line imaging for suspected midgut volvulus varies widely across regions. Barriers to adoption reflect local staffing and training models, and formal published guidelines were frequently identified as a potential facilitator of broader implementation.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031250","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/s00247-026-06788-8","DOIUrl":"https://doi.org/10.1007/s00247-026-06788-8","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017483","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":"Predictors of clinically significant hemorrhage following ultrasound-guided percutaneous renal biopsy in pediatric patients.","authors":"Rajkumar Meena, Nick Barrowman, Anne Tsampalieros, Gali Shapira-Zaltsberg","doi":"10.1007/s00247-026-06794-w","DOIUrl":"https://doi.org/10.1007/s00247-026-06794-w","url":null,"abstract":"<p><strong>Background: </strong>Ultrasound-guided percutaneous renal biopsy is a cornerstone in the evaluation of pediatric kidney disease, with post-biopsy hemorrhage being the most common complication. Multiple predictors of post-biopsy bleeding have been identified in the adult population; however, data on risk factors in children is limited.</p><p><strong>Objective: </strong>The purpose of our study is to determine any risk factors of post-biopsy hemorrhage in children.</p><p><strong>Materials and methods: </strong>This IRB-approved retrospective study included pediatric patients who had native or transplant renal biopsy between 2010-2024. The primary outcomes included decrease of hemoglobin of >15 g/L measured 4-6 h post biopsy and/or presence of a sizable perinephric hematoma (defined as ≥5 mL) measured on immediate post-biopsy ultrasound. The association between presence of hematoma and significant change in Hb was assessed, and the association of 12 different preselected risk factors with these co-primary outcomes was analyzed.</p><p><strong>Results: </strong>Among 207 patients included (median age 11 years [IQR, 7-14]), 170 (82%) underwent native kidney biopsy and 37 (18%) transplant kidney biopsy. A post-biopsy hemoglobin decrease ≥15 g/L occurred in 23 patients (11%; 95% CI, 8-16%), and 27 (13%; 95% CI, 9-18%) developed a sizable perinephric hematoma. A hematoma ≥5 mL on immediate post-procedural imaging was associated with a hemoglobin decrease ≥15 g/L (OR 4.6, 95% CI 1.5-13.4; P=0.004). No other factors were significantly associated with hemoglobin decline or hematoma after correction for multiple testing.</p><p><strong>Conclusion: </strong>Immediate post-biopsy ultrasound findings may help predict clinically significant post-biopsy hemorrhage, while no other risk factors were identified.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008796","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":"Maintaining a healthy work environment with hybrid and remote pediatric radiologists.","authors":"Sakura Noda, M Alp Oztek, John Ward, Vinay Pai, Ramesh S Iyer","doi":"10.1007/s00247-026-06782-0","DOIUrl":"https://doi.org/10.1007/s00247-026-06782-0","url":null,"abstract":"<p><p>Providing hybrid and remote work opportunities has allowed pediatric radiology groups to recruit and retain in the setting of a national and international shortage of pediatric radiologists. The necessity of off-site radiologists from an operational perspective should be thoughtfully balanced against maintaining visibility in decision-making spheres both within and outside of radiology, particularly as the role of radiologists is being challenged by proponents of artificial intelligence. Problems that may arise due to a hybrid and remote model include interpersonal friction due to real or perceived inequities and decreased quality of informal mentorship and trainee education, potentially narrowing the pipeline of future pediatric radiologists. In our practice, we have attempted to mitigate these concerns by prioritizing fairness, avoiding siloing and overemphasis on individual work relative value units (wRVUs), and frequent multidirectional communication.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002315","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":"Cumulative ionizing radiation exposure in pediatric patients with chronic diseases: a narrative review.","authors":"Ance Eimane, Mariantonietta Francavilla, Artūrs Grigorjevs, Claudio Granata, Ione Limantoro, Bogdan-Stefan Olteanu, Carmelo Sofia, Rutger A J Nievelstein, Marek Kardos, Joanna Kasznia-Brown, Sergio Salerno, Ilze Apine","doi":"10.1007/s00247-026-06785-x","DOIUrl":"https://doi.org/10.1007/s00247-026-06785-x","url":null,"abstract":"<p><p>Pediatric patients with chronic diseases commonly experience frequent imaging, which is likely to result in significant cumulative exposure to ionizing radiation. A review of the literature on cumulative and effective radiation doses reported in non-oncologic pediatric chronic disease populations was conducted; 129 records were identified through searches in the SCOPUS, PubMed, and Web of Science databases, and data on disease type, imaging modalities used, and reported dose metrics were extracted. Across the 41 included studies, radiation exposure was influenced by diagnosis, age at first imaging, disease severity, and imaging modality. Plain radiography was the modality used most frequently; however, computed tomography (CT) and fluoroscopy accounted for the majority of cumulative effective dose, in some patient groups exceeding 20-50 mSv. The findings highlight the importance of evidence-based radiation protection referral guidelines, standardized imaging protocols, and dose reporting to support safer imaging practices in this vulnerable population.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956388","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":"Development and evaluation of a deep learning model for computer-aided diagnosis of neonatal pneumothorax on chest radiographs.","authors":"Yohei Sanmoto, Qihao Gao, Daisuke Hitaka, Xin Zhu, Kouji Masumoto","doi":"10.1007/s00247-026-06778-w","DOIUrl":"10.1007/s00247-026-06778-w","url":null,"abstract":"<p><strong>Background: </strong>Neonatal pneumothorax can progress rapidly, yet detection on supine chest radiographs remains challenging.</p><p><strong>Objective: </strong>To develop and evaluate an artificial intelligence model for detecting pneumothorax on supine neonatal chest radiographs.</p><p><strong>Materials and methods: </strong>This retrospective single-center study included neonates admitted to the neonatal intensive care unit between January 2011 and December 2024. The dataset comprised 648 radiographs from 288 neonates with pneumothorax and 5,511 radiographs from 3,377 controls. A ResNet-18-based model was developed using publicly available normal adult chest radiographs for pre-training and knowledge distillation. Data were split at the patient level into training, validation, and test sets. Eight-fold cross-validation determined a fixed probability threshold applied for the test set. Gradient-weighted class activation mapping (Grad-CAM) was used for lung-level localization, and logistic regression identified factors associated with misclassification.</p><p><strong>Results: </strong>In the test dataset, the model achieved an area under the curve of 0.975 (95% confidence interval (CI), 0.961-0.986; sensitivity, 87.6%; specificity, 95.3%; accuracy, 94.5%; positive predictive value, 68.5%; negative predictive value, 98.5%). Grad-CAM localization corresponded to the clinically determined side in 84 of 92 right-lung instances (91.3%) and 48 of 71 left-lung instances (67.6%) (P<0.001). Transient tachypnea of the newborn and gestational age were independently associated with misclassification (OR, 1.88; 95% CI, 1.14-3.12; P=0.03 and OR, 1.10; 95% CI, 1.01-1.19; P=0.03, respectively).</p><p><strong>Conclusion: </strong>The model showed promising diagnostic performance for detecting pneumothorax on supine neonatal chest radiographs. Underlying pulmonary abnormalities may influence model performance, and external validation is warranted before clinical implementation.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956327","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":"Musculoskeletal ultrasonography of lower extremity entheses in children and adolescents - a pilot study of normal B-mode and Doppler characteristics.","authors":"Sandra Hansmann, Johannes Roth","doi":"10.1007/s00247-026-06784-y","DOIUrl":"https://doi.org/10.1007/s00247-026-06784-y","url":null,"abstract":"<p><strong>Background: </strong>Musculoskeletal ultrasonography is an important imaging modality in children. Features of arthritis are well defined and age-related normative data exist. Data on entheses are limited with no consensus on definition of pathology.</p><p><strong>Objectives: </strong>The aim of this pilot study was to evaluate entheseal thickness, echotexture, and presence of vascularity in healthy children and adolescents as a prerequisite for distinction from pathology.</p><p><strong>Materials and methods: </strong>Children and adolescents without musculoskeletal conditions underwent standardized B-mode and power Doppler ultrasonography of the dominant hip, knee, and ankle entheses. Entheseal thickness, echotexture, and vascularity were assessed, alongside demographic, puberty, and physical activity data. Statistical analysis included intraclass correlation coefficients, single regression, and t-tests.</p><p><strong>Results: </strong>Seventy-nine healthy participants (mean age 10.5 years; 48% female) were included. All 782 evaluated entheses showed normal B-mode echotexture. Inter- and intraobserver reliability was high to excellent, with intraclass correlation coefficient values ranging from 0.84-0.99 and 0.91-0.99, respectively. Entheseal thickness correlated significantly with age (r = 0.65-0.90), lacking sex-specific differences at most sites. Minor power Doppler activity was detected in 1-44% of entheses within 2 mm of the insertion, increasing to 2-68% within 5 mm. Doppler signals were most frequent at proximal sartorius and knee entheses.</p><p><strong>Conclusion: </strong>Entheseal thickness correlates with age, but sex differences are minimal. Mild signals are common at the sartorius, quadriceps, and Achilles entheses with normal B-mode findings. Pathologic Doppler may require accompanying B-mode abnormalities. These data broaden the base for ultrasonography of pediatric entheses and facilitate differentiation of pathology from normal findings.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956378","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 two-stage deep learning pipeline for automated detection and localization of endotracheal tubes on pediatric chest radiographs: a pilot study.","authors":"Hailong Li, Bohan Zhang, Elanchezhian Somasundaram, Mahdieh Shabanian, Zachary Taylor, Neeraja Mahalingam, Zhixiu Lu, Bin Zhang, Stephen W Standage, Gary R Schooler, Lili He, Alexander J Towbin","doi":"10.1007/s00247-026-06767-z","DOIUrl":"https://doi.org/10.1007/s00247-026-06767-z","url":null,"abstract":"<p><strong>Background: </strong>Endotracheal tubes (ETTs) are critical life-support devices for mechanically ventilated pediatric patients, yet automated ETT assessment on pediatric chest radiographs (CXRs) remains limited.</p><p><strong>Objective: </strong>To develop and evaluate a two-stage deep learning pipeline for automated detection and localization of ETTs on pediatric CXRs.</p><p><strong>Materials and methods: </strong>This retrospective study included 1,000 pediatric CXRs (476 ETT-positive, 524 ETT-negative) acquired in 2021 at a single institution. ETT segmentation masks and distal tip coordinates were annotated by trained analysts and verified by pediatric radiologists. A two-stage pipeline consisting of a ResNet classification model followed by a U-Net segmentation model was developed for ETT detection and localization. Performance was evaluated on a held-out test set using multiple metrics, including the area under the receiver operating characteristic curve (AUROC) and the mean absolute error (MAE), with 95% confidence intervals (CI). Inter-observer variability was assessed as a reference for localization performance.</p><p><strong>Results: </strong>Inter-observer variability for ETT tip localization was 2.01 mm MAE on the held-out test set. The pipeline achieved an AUROC of 0.994 (95% CI 0.986, 1.000) for ETT detection. For localization, the pipeline achieved a MAE of 6.59 mm (95% CI 5.19, 8.21 mm). Incorporating the classification stage substantially reduced false-positive segmentations from 17 to 3 among ETT-negative CXRs compared with the standalone segmentation model.</p><p><strong>Conclusion: </strong>A two-stage deep learning pipeline demonstrated high performance for automated ETT detection and promising performance for tip localization on pediatric CXRs in this single-center pilot study. Further evaluation in larger and external pediatric cohorts is needed to assess generalizability.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945552","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}