Pediatric Radiology最新文献

{"title":"Magnetic resonance cholangiopancreatography for suspected cholangiopathy in children and young adults: a multi-reader agreement study.","authors":"Pradipta Debnath, Nadeen K Abu Ata, Joseph Y Cao, Shailee V Lala, Archana Malik, Erica L Riedesel, Gary R Schooler, Narendra S Shet, Leslie H Spence, A Luana Stanescu, Bin Zhang, Jean A Tkach, Leticia Khendek, Alexander G Miethke, Andrew T Trout, Jonathan R Dillman","doi":"10.1007/s00247-025-06173-x","DOIUrl":"10.1007/s00247-025-06173-x","url":null,"abstract":"<p><strong>Background: </strong>Magnetic resonance cholangiopancreatography (MRCP) is used to diagnose and monitor primary sclerosing cholangitis (PSC).</p><p><strong>Objective: </strong>To assess inter-reader agreement for the diagnosis of PSC/autoimmune sclerosing cholangitis (ASC) and for individual MRCP features of cholangiopathy in a pediatric sample.</p><p><strong>Materials and methods: </strong>This was a retrospective, IRB-approved study that included MRCP examinations from patients <21 years old with known or suspected cholangiopathy. Multiple biliary and hepatic imaging features were assessed independently by nine pediatric radiologists using 2D and 3D MRCP images. Kappa (κ) statistics and intra-class correlation coefficients (ICC) with 95% confidence intervals (CI) were used to measure inter-reader agreement.</p><p><strong>Results: </strong>Seventy-five patients were included (median age=16.8 [IQR 13.8-18.7] years; 48 boys); 22.7% (17/75) had PSC, 22.7% (17/75) had ASC, and 54.7% (41/75) had other diagnoses. Among observers, agreement was only slight for presence of cholangiopathy (κ=0.15 [95% CI 0.07 to 0.23]) and presence of PSC/ASC (κ=0.13 [0.06 to 0.21]). Agreement was poor for categorical intrahepatic stricture number (κ=-0.002 [(-0.16 to 0.15]) and stricture extent (κ=-0.06 [-0.09 to-0.02]). Agreement was slight for presence of intrahepatic stricturing disease (κ=0.08 [0.04 to 0.12]). Most other findings had fair agreement between readers (including intrahepatic focal dilations, intrahepatic and extrahepatic diverticula, diffuse extrahepatic dilation without stricture, bile duct mural thickening, and biliary obstruction [κ=0.22 to 0.34]). There was moderate agreement for categorical extrahepatic stricture length (κ=0.46 [-0.11 to 1]) and presence of extrahepatic biliary dilation (κ=0.53 [0.40 to 0.65]). There was excellent agreement for extrahepatic bile duct maximum diameter (ICC=0.89 [0.85 to 0.92]).</p><p><strong>Conclusion: </strong>Inter-reader agreement for interpreting MRCP in children and young adults is slight to fair for the diagnosis of PSC/ASC and for most findings of cholangiopathy.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"479-487"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190000","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":"Alobar holoprosencephaly with cyclopia and proboscis.","authors":"Mehmet Atalar","doi":"10.1007/s00247-024-06121-1","DOIUrl":"10.1007/s00247-024-06121-1","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"587"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896522","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":"Ultrasonographic diagnosis and follow-up of a special type of giant fetal hepatic hemangioma.","authors":"Xiaoyan Weng, Juan Jiang, Gang Wen","doi":"10.1007/s00247-025-06196-4","DOIUrl":"https://doi.org/10.1007/s00247-025-06196-4","url":null,"abstract":"<p><p>We present a case of giant fetal hepatic hemangioma to illustrate the impact of ultrasound monitoring on treatment outcomes. Prenatal ultrasound revealed cardiac enlargement, leading to a cesarean section. The neonate had multiple vascular anomalies, including hepatic artery-portal fistula, portal-hepatic venous fistula, and a giant arteriovenous fistula for the abnormal right internal thoracic artery with portal vein, causing progressive pulmonary hypertension. Postnatal embolization and propranolol treatment resulted in significant tumor shrinkage on ultrasonography and resolution by age 2 years. This report highlights the value of detailed prenatal ultrasound monitoring in guiding effective treatment and improving outcomes for giant fetal hepatic hemangioma, a rare but potentially life-threatening condition.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516132","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":"Assessment of sacroiliitis using zero echo time magnetic resonance imaging: a comprehensive evaluation.","authors":"Yunus Emre Bayrak, Törehan Özer, Yonca Anik, Sibel Balci, Duygu Aydin, Nihal Şahin, Hafize Emine Sönmez","doi":"10.1007/s00247-025-06201-w","DOIUrl":"https://doi.org/10.1007/s00247-025-06201-w","url":null,"abstract":"<p><strong>Background: </strong>Enthesitis-related arthritis (ERA), a subset of juvenile idiopathic arthritis (JIA), is characterized by frequent involvement of the sacroiliac (SI) joints.</p><p><strong>Objective: </strong>The aim of this study was to assess the effectiveness of zero echo time (ZTE) magnetic resonance imaging (MRI) in identifying structural lesions in patients with ERA. Conventional MRI pulse sequences often struggle to adequately visualize osseous and calcified tissues.</p><p><strong>Materials and methods: </strong>All MRI examinations were conducted using a 1.5-T (T) scanner. The MRI protocol included standard sequences such as fat-suppressed axial T2-weighted, axial T1-weighted, coronal short tau inversion recovery (STIR), and axial T2-weighted sequences. In addition to conventional MRI, a ZTE sequence was employed. Low-dose computed tomography (CT) served as the reference standard and was performed using a 640-multislice CT device. Structural lesions, including erosions, sclerosis, and changes in joint space, were compared between imaging modalities.</p><p><strong>Results: </strong>A total of 20 patients were included in the study (12 boys, 8 girls), with a median age at diagnosis of 14 years. ZTE-MRI demonstrated similar sensitivity to low-dose CT in detecting erosion (7 vs 8, P = 0.707). The interclass correlation coefficient (ICC) between low-dose CT and ZTE-MRI was 0.993 (P < 0.001), indicating excellent agreement. Moreover, ZTE-MRI showed strong agreement with low-dose CT in detecting sclerosis (ICC = 0.954, P < 0.001) and changes in joint space (ICC = 0.998, P < 0.001).</p><p><strong>Conclusions: </strong>Zero echo time imaging shows promise in providing sacroiliac joint visualization comparable to low-dose CT scans, thereby improving the detection of subtle erosion and sclerosis in these joints.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493195","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":"Cerebrolith in hydranencephaly.","authors":"Mehmet Atalar","doi":"10.1007/s00247-025-06200-x","DOIUrl":"https://doi.org/10.1007/s00247-025-06200-x","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493198","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":"Type IIA pulmonary artery sling with tracheobronchial anomalies.","authors":"Wen-Rong Li, Zhi-Gang Yang, Ke Shi","doi":"10.1007/s00247-025-06197-3","DOIUrl":"https://doi.org/10.1007/s00247-025-06197-3","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476065","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":"Application of simple preparation for pediatric magnetic resonance imaging: a multicenter study in Japan.","authors":"Naomi Sawada, Jun-Ichi Kawada, Shuichi Kito, Toshiki Takeo, Hajime Narita, Mai Fukushima, Yu Masuda, Takamasa Mitsumatsu, Yoshihiko Kawano, Yoko Sakaguchi, Nobuhiro Nishio, Hiroyuki Kidokoro, Yoshiaki Sato, Yoshiyuki Takahashi","doi":"10.1007/s00247-025-06194-6","DOIUrl":"https://doi.org/10.1007/s00247-025-06194-6","url":null,"abstract":"<p><strong>Background: </strong>Sedation with anesthetic medication is often required to perform magnetic resonance imaging (MRI) scans in young children. However, sedation involves risks, particularly respiratory depression. Therefore, it is crucial to explore methods enabling young children to undergo MRI scans without sedation. Additionally, developing MRI preparation techniques for young children that are feasible in general hospitals-without specialized staff or equipment-has become increasingly desirable.</p><p><strong>Objective: </strong>This study aimed to develop a straightforward preparation method for pediatric MRI scans and evaluate its effectiveness.</p><p><strong>Materials and methods: </strong>We prospectively enrolled 43 children ages 4-6 years (mean age, 5.8 years) who were scheduled for MRI scans at five general hospitals. Patients requiring urgent MRI scans were excluded from the study. We provided simple preparations created by child life specialists to help children and guardians easily understand MRI scans. A historical control group comprised 44 consecutive children, ages 4-6 years, who had undergone MRI scans before this preparatory intervention was introduced.</p><p><strong>Results: </strong>Following the introduction of the preparation, a significantly higher percentage of patients attempted MRI scans without sedation than historical controls (60.5% vs. 15.9%, P < 0.001). Additionally, the success rate of performing MRI without sedation increased markedly (53.5% vs. 13.6%, P < 0.001).</p><p><strong>Conclusion: </strong>Introducing the simple preparation allowed for more successful non-sedated MRI scans in children ages 4-6 years. This preparation may contribute to higher rates of successful non-sedated MRIs among children in general hospitals, even in settings lacking specialized staff or equipment.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458807","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":"Is that bowel normal? Nomograms for fetal colon and rectum measurements by MRI from 20-36 weeks' gestation.","authors":"Caroline J Walsh, Jered T Nystrom, Lori J Silveira, Mariana L Meyers","doi":"10.1007/s00247-025-06192-8","DOIUrl":"https://doi.org/10.1007/s00247-025-06192-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;MRI is being increasingly used as a supplemental tool to ultrasound for prenatal diagnosis of fetal anomalies. Evidence suggests fetal MRI may aid in diagnosis and management of gastrointestinal abnormalities, though it is not widely used for this indication at this time. There is a lack of well-established nomograms of fetal colonic measurements by gestational age (GA) with MRI.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We aim to establish a nomogram of normal colonic and rectal size throughout the second and third trimesters by fetal MRI, starting at a younger GA than previously documented.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods and materials: &lt;/strong&gt;A retrospective study was performed. Fetal MRI databases spanning October 2010 to June 2021 were searched for examinations performed from 19 weeks GA to term. Cases were excluded for poor image quality or if a gastrointestinal abnormality was noted. Coronal and sagittal T1-weighted images were used to measure the ascending, transverse, descending, and sigmoid colon; rectosigmoid colon (at the level of the iliac crest); and rectum (at the distal third in the coronal views and at the base of the bladder and largest dimension in the sagittal views, at the orthogonal plane of the colon). Reproducible measurement areas for fetal bowel were established between two readers, and two-way mixed single-measure intra-class correlation coefficients (ICCs) were developed to assess inter-rater reliability. Growth curves were developed using generalized additive models. The main outcomes were the measurements at each section of the bowel and the predictor was GA. The curves of the fitted models were plotted for the estimated 10th, 25th, 50th, 75th, and 90th percentiles.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 315 patients had at least one measurable bowel segment. If 100 or more measurements were obtained at a bowel segment, a nomogram was created. Due to limited available data prior to 20 weeks and after 36 weeks GA, bowel nomograms were developed for 20-36 weeks GA. The three bowel segments with the most included patients and greatest number of measurements obtained were the rectosigmoid colon at the iliac crest, distal one-third of the rectum, and the sigmoid colon (n = 251, 234, 178, respectively) with excellent reader agreement (ICC = 0.96, 0.90, 0.94, respectively). The range of bowel diameter increased with advancing GA at the 10th percentile through the 90th percentile in a nearly linear distribution at the sigmoid colon, rectum at the base of the bladder, and distal rectum and in a non-linear distribution at the rectum at the level of the iliac crest and descending colon.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our study provides normative data for fetal colon and rectum measurements from 20 to 36 weeks GA on MRI. Radiologists can reliably measure the normal fetal colon and rectum on fetal MRI. Our nomogram of normal fetal bowel measurements provides radiologists and clinicians with data that can a","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458809","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":"Opportunistic screening for bone mineral density deficits in pediatric patients from abdominal computed tomography scans obtained for other indications: a cross-sectional study.","authors":"Chuan Liu, Dandan Yang, Xijian Chen, Yi Liao, Gang Ning, Haibo Qu","doi":"10.1007/s00247-025-06195-5","DOIUrl":"https://doi.org/10.1007/s00247-025-06195-5","url":null,"abstract":"<p><strong>Background: </strong>Quantitative computed tomography (QCT) has been widely applied for opportunistic screening for osteoporosis in adults, but it is rarely used in pediatric patients.</p><p><strong>Objective: </strong>This study aimed to investigate the feasibility of QCT and the prevalence of bone mineral density (BMD) deficits at the spine in pediatric patients undergoing an abdominal computed tomography (CT) for other indications.</p><p><strong>Materials and methods: </strong>Pediatric patients who underwent a clinical abdominal CT scan from October 2018 to November 2020 were recruited for this retrospective cross-sectional study. Lumbar trabecular BMD was evaluated by QCT. The relationships of treatment variables and other potential risk factors with low BMD were analyzed via the signed-rank test and logistic regression analysis.</p><p><strong>Results: </strong>A total of 748 pediatric patients were included. The QCT scans revealed low lumbar BMD (Z-score ≤ -2) in 86 (11.5%) patients. A history of chemotherapy or radiation therapy (β = 3.925, P < 0.001), a history of chronic corticosteroid exposure (β = 4.852, P < 0.001), older age (10.0-17.9 years vs. 1.0-9.9 years; β = 2.306, P = 0.001), and short stature (height ≤ the 3rd percentile vs. height > the 3rd percentile; β = 1.920, P = 0.047) were significantly associated with low BMD in pediatric patients.</p><p><strong>Conclusion: </strong>QCT could be applied for opportunistic screening for low BMD in pediatric patients. Patients with cancer or renal disease, or those with a history of chemotherapy, radiation therapy, or chronic corticosteroid exposure, have a greater incidence of low BMD and constitute high-risk populations for BMD loss.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441738","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":"Radiological and clinical signatures to differentiate hepatocellular carcinoma from hepatoblastoma in children older than 5 years of age: a feasibility study.","authors":"Gozde Ozer, H Nursun Ozcan, Burak Ardicli, Tezer Kutluk, Berna Oguz, Mithat Haliloglu","doi":"10.1007/s00247-025-06190-w","DOIUrl":"https://doi.org/10.1007/s00247-025-06190-w","url":null,"abstract":"<p><strong>Background: </strong>Hepatoblastoma and hepatocellular carcinoma (HCC) are the most common primary malignant liver tumors in children. Although some characteristic imaging findings have been described in both hepatoblastoma and HCC, it is difficult to distinguish between these two tumors over the 5 years of age.</p><p><strong>Objective: </strong>To investigate clinical and radiological findings that may help differentiate hepatoblastoma and HCC over 5 years of age.</p><p><strong>Materials and methods: </strong>From 2007 to 2022, 19 consecutive patients older than 5 years old diagnosed with primary liver malignancy were yielded from our radiology archive retrospectively. Imaging features, age, sex, treatment, and follow-up data were recorded.</p><p><strong>Results: </strong>A total of 19 patients (16 boys; median age 7.5, min-max 5-17), ten HCCs and nine hepatoblastomas, were included. Serum alpha-fetoprotein (sAFP) values were significantly higher in hepatoblastoma patients (n=9), compared to the HCC (n=10) (P=0.002). Tumor size and PRETEXT stages were higher in hepatoblastoma patients; however, there was no statistical difference (P=0.06). Initial MRI was available for six patients with hepatoblastoma and seven patients with HCC, and there was no difference regarding ADCmin values.</p><p><strong>Conclusion: </strong>In the differential diagnosis of primary malignant liver tumor in a child older than 5 years of age, higher sAFP level may support the diagnosis of hepatoblastoma rather than HCC.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441762","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}