Pediatric Radiology最新文献

{"title":"Practical approach to extracardiac findings in CT and MR for the non-radiologist.","authors":"Alan V Godfrey, Erin K Opfer, Neil J Mardis","doi":"10.1007/s00247-024-06150-w","DOIUrl":"https://doi.org/10.1007/s00247-024-06150-w","url":null,"abstract":"<p><p>Cross-sectional cardiac imaging plays an essential role in the evaluation of pediatric patients with congenital and acquired heart disease. While the focus of cardiac imaging is primarily on evaluating cardiac structures, it also provides valuable insights into extracardiac structures and associated abnormalities. The radiologists and cardiologists interpreting these exams play a critical role in recognizing these findings and providing recommendations for follow-up testing when indicated. Due to the excellent soft tissue resolution of cardiac magnetic resonance imaging (MRI) and computed tomography (CT), incidental findings can often be diagnosed without further imaging. Incidental findings are generally defined as lesions or masses detected by imaging that is performed for a different reason. In other cases, further imaging evaluation and testing may be necessary. This article aims to explore the spectrum of extracardiac findings encountered in pediatric cardiac imaging studies, their clinical significance, and the potential implications for patient care.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009438","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":"Paula Brill (1938-2024).","authors":"Arzu Kovanlikaya, Terry L Levin","doi":"10.1007/s00247-024-06148-4","DOIUrl":"https://doi.org/10.1007/s00247-024-06148-4","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984573","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":"Technical considerations of cardiac computed tomography in children.","authors":"Lauren A May, Lamya A Atweh, Prakash Masand, Siddharth P Jadhav","doi":"10.1007/s00247-024-06143-9","DOIUrl":"https://doi.org/10.1007/s00247-024-06143-9","url":null,"abstract":"<p><p>Cardiac computed tomography angiography (CTA) is a valuable tool in the assessment of congenital and acquired cardiac disease in children. The goal of cardiac CTA is to produce images that are free of motion and provide sufficient characterization of the anatomy in question. Given the complexity of pediatric patient characteristics, including patient size, heart rate, breath-holding capability, and variant anatomy, cardiac CTA technique must be individualized to the patient as well as the indication to answer the clinical question while also minimizing radiation exposure. The purpose of this article is to discuss the variables that can be adjusted to optimize imaging including cardiac gating, scanner specifications and computed tomography technique, temporal resolution, contrast resolution, intravenous access, and contrast administration.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984574","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":"Skeletal surveys for suspected infant abuse: patient-specific radiation dose estimation using a hybrid computational phantom.","authors":"Danielle Beaulieu, Da Zhang, Jeannette M Pérez-Rosselló, Reyhaneh Nosrati, Choonsik Lee, Andy Tsai","doi":"10.1007/s00247-024-06157-3","DOIUrl":"https://doi.org/10.1007/s00247-024-06157-3","url":null,"abstract":"<p><strong>Background: </strong>Radiographic skeletal survey plays an important role in the diagnosis of infant abuse. Some practitioners have expressed concerns about the radiation exposure from this examination.</p><p><strong>Objective: </strong>To utilize state-of-the-art hybrid computational phantoms to more accurately estimate radiation doses of skeletal surveys performed for suspected infant abuse.</p><p><strong>Materials and methods: </strong>We searched our imaging database to identify skeletal surveys performed for suspected infant abuse (5/2020-5/2022). Initial skeletal surveys consisted of 25 standardized radiographs while follow-up skeletal surveys consisted of 16 standardized radiographs (no frontal or lateral views of the skull; or lateral views of the spine, knees, and ankles). To estimate the patient-specific organ and effective dose, we applied the National Cancer Institute dosimetry system for Radiography and Fluoroscopy (with on-the-fly 3D Monte Carlo simulation) to the male and female infant hybrid computational phantoms.</p><p><strong>Results: </strong>The mean total effective radiation dose was 0.627 mSv (initial survey) and 0.495 mSv (follow-up survey). For both surveys, the anteroposterior chest radiograph was the largest contributor to effective dose (contributing 0.101 mSv and 0.108 mSv, respectively). In the initial skeletal survey, the lens and the eyeballs received the highest organ absorbed doses (with the skull radiographs as the major contributors); and in the follow-up skeletal survey, the breasts received the highest organ absorbed dose (with the chest radiographs as the major contributors).</p><p><strong>Conclusions: </strong>We employed hybrid computational phantoms to better estimate the radiation profile of skeletal surveys performed for suspected infant abuse, thus enabling us to update and optimize this life-saving imaging protocol.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978798","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":"Impact of trauma center status on radiology resident performance in detecting non-accidental trauma on the WIDI SIM exam.","authors":"Kevin Pierre, Abheek Raviprasad, Jay Talati, Isabella Amador, Alexandria Iakovidis, Christopher Sistrom, Roberta Slater, Linda Lanier, Evelyn Anthony, Anthony Mancuso, Dhanashree Rajderkar, Priya Sharma","doi":"10.1007/s00247-024-06158-2","DOIUrl":"https://doi.org/10.1007/s00247-024-06158-2","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether adult and pediatric trauma center status, as well as the presence of dedicated child protection teams, influences radiology resident performance in detecting non-accidental trauma on the Emergent/Critical Care Imaging Simulation (WIDI SIM) exam.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 639 WIDI SIM exam scores for four pediatric non-accidental trauma cases completed by radiology residents across 33 programs. Residents were stratified by level (R1-R4) and institutional factors, including adult trauma center status, pediatric trauma center status, and child protection team presence. Additionally, 2022 pediatric physical abuse counts per state were obtained from the National Child Abuse and Neglect Data System and normalized between 0 and 1. We employed a negative binomial generalized linear model (GLM). The outcome was regressed on resident level, trauma center status variables, child protection team presence, and normalized abuse counts.</p><p><strong>Results: </strong>Higher resident training level was significantly associated with better performance (R1=3.6, R2=5, R3=6.1, R4=7.9; P<0.001). Adult trauma center accreditation was also associated with higher scores (4.6 vs. 3.3; P<0.001). In contrast, pediatric trauma center status, child protection team presence, and normalized state-level abuse counts were not significantly associated with resident performance (all P>0.05).</p><p><strong>Conclusion: </strong>Resident experience and adult trauma center accreditation were significantly associated with better radiology resident performance in detecting non-accidental trauma in a simulated call environment. Pediatric trauma center status, child protection team presence, and statewide abuse prevalence were not associated with detection performance. These findings suggest the need for targeted educational interventions at non-adult trauma centers and emphasize the importance of experience in developing diagnostic proficiency for non-accidental trauma.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979541","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":"Time-driven cost analysis of pediatric liver biopsy completed in pediatric sedation clinic and operating room.","authors":"Kylie K Ruprecht, Katryn N Furuya, Jonathan O Swanson, Eric J Monroe","doi":"10.1007/s00247-024-06142-w","DOIUrl":"https://doi.org/10.1007/s00247-024-06142-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Pediatric ultrasound (US)-guided percutaneous liver biopsy is a commonly performed procedure in children, and may be performed in a variety of clinical settings. However, there is little research on the relative costs associated with different sedation methods and locations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study uses time-driven activity-based costing (TDABC) to identify relevant costs associated with different biopsy sedation techniques and locations to help inform providers and patients as well as guide value-conscious care. This study analyzes the direct costs associated with pediatric liver biopsy performed in an OR versus a dedicated pediatric sedation clinic.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;A single-center retrospective review including data from consecutive procedures all completed by one board-certified interventional radiology physician between June 2021 and April 2024 was performed. Exclusion criteria included procedures with lack of timestamps (N = 3), and multiple procedures being completed causing a deviation from the standard pathway process (N = 19). Direct costs were calculated using cost capacity rates (CCR) and TDABC methodology. Propensity score matching between procedures performed in a sedation clinic versus an operating room (OR) was performed adjusting for age, gender, American Society of Anesthesiologists (ASA) status, and inpatient status, and subsequent matches were analyzed via paired t-test in SPSS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 111 procedures performed in the OR (N = 71) or sedation clinic (N = 40) were found and considered for analysis (N = 55 male, N = 56 female; mean age = 9.13, SD = 6.69 years). A technical success rate of 100% and a complication frequency of 5% (N = 3, mean = 13.67, SD = 2.05, all grade 1) were observed. Complication frequency was not statistically significant between the sedation clinic (N = 1) and OR (N = 2) groups (P = 0.28). After propensity matching, N = 58 matched procedures (OR, N = 29; sedation clinic, N = 29) were included. Pre-procedure times in the sedation clinic were shorter in duration (62.11 ± 42.25) than in the OR (111.96 ± 62.11, P &lt; 0.001). Total procedure times were also shorter in duration in the sedation clinic (14.07 ± 4.99) than in the OR (21.76 ± 18.22, P = 0.03). In addition, procedures completed in the OR utilized additional anesthesia staff for an average of 72 min, contributing to overall cost. The average total included costs for matched liver biopsy procedures were $1,089.51 ± 384.34 in the sedation clinic and $2,801.36 ± 1,201.52 in the OR (P &lt; 0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Liver biopsies completed in the sedation clinic were associated with significantly lower direct costs and were not associated with higher complication rates. These findings provide evidence for promoting pediatric sedation clinics as a safe and cost-effective location to perform liver biopsies in appropriate patients.","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979288","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":"Abdominopelvic tumors of infancy: a pictorial essay.","authors":"Abubakr O Bajaber, Mody A Almarshad, Ahmed I Aldraihem, Aljoharah A Aljabr","doi":"10.1007/s00247-024-06147-5","DOIUrl":"https://doi.org/10.1007/s00247-024-06147-5","url":null,"abstract":"<p><p>Abdominal and pelvic masses in infants present significant challenges for healthcare professionals and can be distressing for parents due to the wide spectrum of both benign and malignant conditions in this age group. This article concentrates on illustrating different types of abdominal and pelvic tumors, both benign and malignant, that occur in infants. It highlights the specific imaging characteristics of these tumors and covers non-neoplastic conditions that may appear similar on imaging. The aim is to aid radiologists in accurately diagnosing these conditions and distinguishing them from other differentials. By combining imaging results with clinical information, healthcare providers can timely identify and manage potentially concerning conditions, ultimately enhancing outcomes and the overall quality of life for affected infants and their families.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965684","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":"Comparing magnetic resonance enterography and endoscopy findings to the motility of magnetic resonance imaging in pediatric Crohn's disease.","authors":"Brianna McSorley, Matthew Plunk, Sai Alekha Chai, Amy Y Pan, Joshua Noe","doi":"10.1007/s00247-024-06129-7","DOIUrl":"https://doi.org/10.1007/s00247-024-06129-7","url":null,"abstract":"<p><strong>Background: </strong>Quantitative magnetic resonance imaging (MRI) can evaluate bowel motility in children with Crohn's disease. As inflammation increases, motility decreases.</p><p><strong>Objective: </strong>Our aim was to show that quantitative MRI correlates with magnetic resonance enterography (MRE). We hypothesize that the motility score will inversely correlate with the Endoscopic Biopsy Acute Histologic Inflammatory Score (eAIS), the Crohn's Disease Endoscopic Index of Severity (CDEIS) score, and the MR Index of Activity (MaRIA) score.</p><p><strong>Materials and methods: </strong>This was a retrospective study of 50 pediatric patients with ileal and/or cecal Crohn's disease who underwent endoscopy and MRE within 7 days of each other without exposure to therapy. Cine images were used from patients' previously obtained MREs to obtain a motility score using GIQuant (Motilent, London, UK). The relationships between the motility score and MaRIA, eAIS, and CDEIS were then calculated by Spearman's rank correlation coefficient (ρ).</p><p><strong>Results: </strong>The MaRIA and motility scores inversely correlated (ρ=-0.66, 95%CI (-0.79, -0.46), P<0.0001). MaRIA positively correlated with CDEIS (ρ=0.30, 95%CI (0.02, 0.53), P=0.03) and eAIS (ρ=0.26, 95%CI (0.02, 0.50), P=0.07). The motility score showed a non-significant negative correlation with CDEIS (ρ=-0.17, 95%CI (-0.43, -0.12), P=0.24) and eAIS (ρ=-0.23, 95%CI (-0.48, -0.05), P=0.11).</p><p><strong>Conclusion: </strong>Quantitative MRI correlates with standard MRE in identifying inflammation of the bowel in Crohn's disease. The cine image used to produce a motility score is obtained faster than standard MRE and does not require the use of intravenous contrast, a spasmolytic agent, and breath-holding techniques.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952608","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 recap of 2024 and plans for the upcoming year.","authors":"Geetika Khanna, Amaka C Offiah","doi":"10.1007/s00247-024-06140-y","DOIUrl":"https://doi.org/10.1007/s00247-024-06140-y","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932144","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":"An introduction to Pediatric Radiology's new section editors (Outside the Americas).","authors":"Amaka C Offiah","doi":"10.1007/s00247-024-06139-5","DOIUrl":"https://doi.org/10.1007/s00247-024-06139-5","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915479","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}