Pediatric Radiology最新文献

{"title":"Laminar pattern disruption in fetal incipient polymicrogyria: insights from post-mortem magnetic resonance imaging and neuropathological correlation.","authors":"Giana Izzo, Mario Tortora, Valentina Toto, Mariano Lanna, Chiara Doneda, Filippo Arrigoni, Fabio Tortora, Cecilia Parazzini, Andrea Righini","doi":"10.1007/s00247-026-06770-4","DOIUrl":"https://doi.org/10.1007/s00247-026-06770-4","url":null,"abstract":"<p><strong>Background: </strong>Polymicrogyria is a heterogeneous cortical malformation resulting from disruption of multiple processes of cortical development, either genetically determined or acquired.</p><p><strong>Objective: </strong>To characterize early imaging and histopathological features of incipient polymicrogyria in fetuses at early gestational age and correlate radiological patterns with underlying etiopathogenic mechanisms.</p><p><strong>Materials and methods: </strong>Four fetuses at 21 weeks' gestational age with suspected polymicrogyria on fetal magnetic resonance imaging underwent post-mortem magnetic resonance imaging (PMMRI) and detailed neuropathological examination, including immunohistochemistry (NeuN, NSE, GFAP, MBP, CD3, CD68). Imaging and histological findings were systematically compared.</p><p><strong>Results: </strong>Distinct imaging-histopathological patterns were identified according to etiology (ischemic, infectious, genetic). Key differentiating features included symmetry of involvement, cerebral surface appearance, integrity of the pial basement membrane, laminar pattern alterations, and associated anomalies.</p><p><strong>Conclusion: </strong>Combined PMMRI and neuropathology enable early characterization of polymicrogyria and provide insights into its etiopathogenesis, improving differential diagnosis and genetic counseling.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897689","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":"The varying neuroradiological manifestations of pediatric dengue central nervous system infection: a pictorial review from Pakistan with literature correlation.","authors":"Kumail Khandwala, Syed Mohammad Hasan, Sahra Khan Mateen, Naila Nadeem, Kiran Hilal","doi":"10.1007/s00247-026-06771-3","DOIUrl":"https://doi.org/10.1007/s00247-026-06771-3","url":null,"abstract":"<p><p>Dengue infection is an increasingly recognized cause of neurological complications in children, with a wide and evolving spectrum of central and peripheral nervous system involvement. This pictorial review systematically illustrates the neuroradiological manifestations of pediatric dengue using a pathophysiology- and imaging pattern-based approach, correlating characteristic magnetic resonance imaging (MRI) findings with the current literature. Neuroimaging manifestations are broadly categorized into direct viral neuroinvasive, immune-mediated, and reversible edema patterns. Direct viral involvement includes meningoencephalitis, deep gray matter involvement, and rhombencephalitis, with severe cases demonstrating the characteristic \"double doughnut\" sign of necrotizing encephalopathy-like encephalitis and the \"Jack-o'-lantern\" sign of pontine involvement. Immune-mediated white matter injury includes acute leukoencephalopathy with restricted diffusion and acute disseminated encephalomyelitis, which differ in their diffusion characteristics and temporal relationship to infection. Reversible edema syndromes include reversible splenial lesion syndrome and the less commonly reported posterior reversible encephalopathy syndrome, both associated with favorable clinical and radiological outcomes. Spinal and peripheral nervous system manifestations include myelitis and Guillain-Barré syndrome, with MRI playing a key role in differentiating these entities from other infectious and inflammatory myeloradiculopathies. Importantly, intralesional hemorrhagic changes on susceptibility-weighted or gradient recalled echo imaging, particularly within the deep gray nuclei and brainstem, represent a valuable imaging marker favoring dengue over several viral and inflammatory mimickers. Recognition of these characteristic pattern-based neuroradiological manifestations and their underlying pathophysiological correlates improves diagnostic confidence, facilitates differentiation from competing diagnoses, and guides timely management of pediatric dengue neurological disease in endemic regions.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897650","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 validation of a novel three-dimensional patient-specific pediatric brain phantom for computed tomography neuroimaging research.","authors":"Hamza Sekkat, Abdessalame El Hafiane, Oussama El Mouden, Imane Brika, Youssef Madkouri, Abdellah Khallouqi, Abdellah Halimi, Omar El Rhazouani","doi":"10.1007/s00247-026-06768-y","DOIUrl":"https://doi.org/10.1007/s00247-026-06768-y","url":null,"abstract":"<p><strong>Background: </strong>Pediatric head computed tomography (CT) is widely used for urgent neuroimaging, but children's higher radiosensitivity makes protocol optimization and quantitative validation essential. Many available phantoms lack patient-specific pediatric anatomy and realistic brain-mimicking attenuation, limiting their relevance for neuro-CT research and benchmarking.</p><p><strong>Objective: </strong>To develop and validate a CT-derived, patient-specific pediatric brain phantom that preserves anatomically faithful geometry and reproduces brain-mimicking soft-tissue attenuation with physics-validated energy dependence.</p><p><strong>Materials and methods: </strong>A fully anonymized head CT of a 5-year-old child was segmented in 3-D Slicer, exported to standard tessellation language (STL), and partitioned into hemispheres. A polylactic acid (PLA) master was three-dimensional (D)-printed to fabricate a reinforced silicone mold. A homogeneous brain-mimicking soft-tissue surrogate was produced by modifying an epoxy system with acetone. The assembled phantom was scanned at 80, 100, 120, and 140 kilovolt peak (kVp). Region of interest (ROI)-based CT numbers were measured across both hemispheres. Computational attenuation verification was performed using Particle and Heavy Ion Transport code System (PHITS) Monte Carlo simulations with a mono-energetic transmission method over 15-150 kiloelectronvolt (keV) and compared with PhyX-Photon Shielding and Dosimetry (PhyX-PSD) and National Institute of Standards and Technology XCOM database (NIST/XCOM) reference.</p><p><strong>Results: </strong>The fabricated phantom preserved the main bilateral morphology and retained 96.85% of the original patient-derived brain volume, with volumes of 1,129.15 cm³ and 1,165.89 cm³, respectively. CT-number and CT-derived mass attenuation coefficient values are reported as mean±standard error of the mean (SEM). At the matched tube voltage of 120 kVp, the mean CT number was 44.94±1.38 Hounsfield units (HU) in the phantom and 40.66±4.13 HU in the source pediatric brain parenchyma, corresponding to an absolute difference of 4.28 HU. Across the complete phantom acquisition series, mean CT numbers increased from 18.55±1.14 HU at 80 kVp to 51.04±0.93 HU at 140 kVp. CT-derived mass attenuation coefficients decreased from 0.1664±0.0002 to 0.1445±0.0001 cm² g^-1 over 80-140 kVp. PHITS-derived attenuation coefficients closely matched the theoretical reference, with relative differences within ±5% across the predefined 15-150 keV diagnostic photon-energy range.</p><p><strong>Conclusions: </strong>This work establishes the feasibility of producing a 3-D patient-specific pediatric brain component with preserved geometry and clinically relevant bulk CT attenuation, providing a methodological basis for subsequent integration of the skull and other structures into a modular complete-head phantom.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888257","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":"Ewing sarcoma of the great toe distal phalanx.","authors":"Daniel Thach, Anthony Zarka","doi":"10.1007/s00247-026-06773-1","DOIUrl":"https://doi.org/10.1007/s00247-026-06773-1","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888319","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":"Detecting the drip: pediatric neuroradiologist guide to spinal CSF leaks.","authors":"Mark D Mamlouk","doi":"10.1007/s00247-026-06764-2","DOIUrl":"https://doi.org/10.1007/s00247-026-06764-2","url":null,"abstract":"<p><p>Pediatric spinal CSF leaks are uncommon and encompass a spectrum of leak types with distinct imaging findings, diagnostic pathways, and treatment strategies. Brain and spine MRI guide the evaluation of suspected CSF leaks and the selection of advanced imaging techniques for precise leak localization. Leak types include dural tears, CSF-venous fistulas, and CSF-vascular malformation fistulas, each with distinct imaging and treatment considerations. This pictorial review illustrates the spectrum of pediatric spinal CSF leaks and provides a practical framework for their diagnosis and management.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881180","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":"Reversible posterior leukoencephalopathy syndrome due to fish gallbladder poisoning in a 15-year-old.","authors":"Qinglin Zhong, Binglin Lai","doi":"10.1007/s00247-026-06649-4","DOIUrl":"10.1007/s00247-026-06649-4","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"2343"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147932446","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 features of pediatric ovarian tumors: a pictorial essay.","authors":"Farzaneh Shobeirian, Sana Sadeghikia, Shabana Rasheed","doi":"10.1007/s00247-026-06652-9","DOIUrl":"10.1007/s00247-026-06652-9","url":null,"abstract":"<p><p>Pediatric ovarian tumors, although rare, require accurate diagnosis through multimodality imaging. This pictorial essay highlights the key radiological features of various ovarian neoplasms in children using ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET-CT). Representative examples illustrate the characteristic imaging features of germ cell tumors, sex cord-stromal tumors, and epithelial tumors, which are essential for accurate diagnosis, guiding management, and preserving fertility in children.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"2176-2189"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147982998","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":"Examination of elevated myocardial extracellular volume and exercise capacity in pediatric Fontan patients at moderate altitude.","authors":"Ernie C Arnouts, Nicolas D Drysdale, Jochen Gerstner Saucedo, Cesar Gonzalez de Alba, LaDonna J Malone, Brian Fonseca, Michael V DiMaria, Lorna P Browne, Alex J Barker","doi":"10.1007/s00247-026-06675-2","DOIUrl":"10.1007/s00247-026-06675-2","url":null,"abstract":"<p><strong>Background: </strong>Diffuse myocardial fibrosis, as measured by T1 (longitudinal relaxation time) mapping and extracellular volume, may be associated with ventricular dysfunction in the Fontan circulation. However, the relationship between diffuse myocardial fibrosis and exercise tolerance, an early and clinically meaningful marker of Fontan physiology, remains incompletely characterized, particularly in pediatric populations.</p><p><strong>Objective: </strong>To evaluate the association between CMR-derived markers of diffuse myocardial fibrosis (native T1 and ECV) and exercise tolerance in pediatric patients with Fontan circulation compared with healthy controls.</p><p><strong>Materials and methods: </strong>A retrospective cohort study of pediatric patients with Fontan circulation who underwent clinically indicated cardiovascular magnetic resonance (CMR) with native and post-contrast T1 mapping between 2019 and 2022 was performed. Global native T1 and ECV were quantified and compared with age- and scanner-matched controls. Cardiopulmonary exercise testing-derived VO₂ max and catheterization parameters obtained within 24 months of CMR were analyzed. Associations between myocardial fibrosis markers and functional measures were assessed using correlation analyses.</p><p><strong>Results: </strong>A cohort of 64 pediatric Fontan patients (median age 11.0 years, interquartile range 7.0-14.0; age range <18 years), and 41 pediatric controls, was stratified by field strength and ventricular dominance. Fontan patients demonstrated increased native T1 values across varying field strengths of 1.5 T (1,035.9 ± 48.7 ms vs 983.8 ± 29.0 ms, P<0.001) and 3 T (1,292.8 ± 53.5 ms vs 1,257.8 ± 41.5 ms, P=0.033), and significantly elevated ECV compared to controls (25.6 ± 3.5% vs 23.2 ± 2.1%, P=0.007). There was no significant difference in native T1 or ECV between dominant right and left ventricles. VO₂ max was markedly reduced in Fontan patients compared to controls (1.2 ± 0.4 liters per minute (LPM) vs 2.5 ± 0.7 LPM, P<0.001). While a broad-inverse correlation between ECV and VO₂ max did not reach statistical significance across the full cohort (R=-0.19, P>0.05), time since Fontan surgery was inversely correlated with ECV (R=-0.27, P<0.05), and localized subgroup correlations emerged between native T1 and exercise capacity.</p><p><strong>Conclusions: </strong>Markers of myocardial fibrosis were elevated among Fontan patients compared to healthy controls. Fontan patients were shown to have reduced exercise tolerance compared to controls as measured by VO2 max. While myocardial ECV is elevated in pediatric Fontan patients, its relationship with impaired exercise capacity is complex and subgroup-specific, suggesting a need for additional study and functional decline may be driven by multifactorial etiologies.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"2260-2271"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148150788","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":"Sequential MR-guided laser and cryoablation of a recurrent painful slow-flow venous malformation in a 6-year-old.","authors":"Ola A E Mohamed, Scott M Thompson, Haraldur Bjarnason, Megha M Tollefson, Setayesh Sotoudehnia Korani, Emily C Bendel, Daniel A Adamo, Angela Bathke, Aiming Lu, David A Woodrum","doi":"10.1007/s00247-026-06666-3","DOIUrl":"10.1007/s00247-026-06666-3","url":null,"abstract":"<p><p>This case report evaluated the utilization of MR-guided ablation for a refractory painful slow-flow vascular malformation in the plantar aspect of the left foot in a 6-year-old male patient. Initially, MR-guided laser ablation was performed followed by MR-guided cryoablation 5 years later. Procedures were performed under general anesthesia using a 1.5-T Philips MRI system with real-time MRI guidance and monitoring. Pain outcomes were assessed using patient-reported improvement. The lesion diameter was 3.7 cm in the longest axis. The patient achieved sustained pain relief for 5 years after the initial laser ablation then MR-guided cryoablation which has given him 6 years of relief so far. No major complications occurred.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"2332-2337"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148302549","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":"Neonatal and early infant intussusception: a 24-year retrospective review from a tertiary referral center.","authors":"Caroline Rutten, Adriana Koenig, Augusto Zani, Alan Daneman","doi":"10.1007/s00247-026-06663-6","DOIUrl":"10.1007/s00247-026-06663-6","url":null,"abstract":"<p><strong>Background: </strong>Intussusception in neonates and young infants is rare, with limited data to guide management.</p><p><strong>Objective: </strong>This study aims to characterize the presentation, management, and outcomes of intussusception in infants ≤100 days of age.</p><p><strong>Materials and methods: </strong>Radiology reports were searched for the keyword \"intussusception\" in infants ≤100 days over a 24-year period (January 1, 2000-July 31, 2024). Patient charts were reviewed, and cases with negative imaging studies were excluded. Data were analyzed for patient demographics, presenting symptoms, imaging, and management approach, including operative or non-operative interventions. Intussusceptions were classified as small bowel-small bowel (SB/SB), enteric tube-related SB/SB, or ileocolic.</p><p><strong>Results: </strong>Of 301 charts reviewed, 124 neonates and young infants ≤100 days of age met inclusion criteria (median age, 55 days; range, 0-100 days). SB/SB intussusception accounted for 94/124 cases (76%), which included 36 (38%) enteric tube-related. Most SB/SB cases were incidental findings, and only two required surgery. Management of enteric tube-related intussusceptions consisted primarily of conservative measures such as tube shortening or removal, with complete resolution and no case requiring surgery. Thirty infants (24%) had ileocolic intussusception. Air enema was attempted in 26, with a success rate of 80% (21/26) and no perforations occurred. Surgical intervention was required in 8 cases, revealing pathologic lead points in 4 cases (duplication cysts - 3; Meckel's diverticulum - 1), corresponding to 13% of ileocolic intussusceptions.</p><p><strong>Conclusion: </strong>SB/SB intussusceptions predominate and rarely require intervention. Ileocolic intussusception accounts for 24% of cases, with air enema proving safe and effective in most cases. Most ileocolic intussusceptions are idiopathic (87%), with pathologic lead points identified in 13%, a higher proportion than reported in older children.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":"2222-2230"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148043281","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}