Pediatric Radiology最新文献

{"title":"Technology, connection, and engagement-achieving a balance for maximal value hybrid conferences in radiology.","authors":"Amanda Liu, Julian Lopez-Rippe, Janet Reid","doi":"10.1007/s00247-025-06187-5","DOIUrl":"https://doi.org/10.1007/s00247-025-06187-5","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 pandemic catalyzed a transformation in medical education, leading to the emergence of hybrid learning formats that combine in-person and remote participation. While this format offers increased flexibility and accessibility, it presents unique challenges for both educators and learners in radiology training programs.</p><p><strong>Methods: </strong>This review examines the critical elements necessary for successful hybrid resident and fellow conferences in radiology education, focusing on three key domains: technology, connection, and engagement.</p><p><strong>Results: </strong>Technical considerations, including appropriate audiovisual setup and the designation of conference moderators, are crucial for seamless integration of remote participants. Digital tools such as audience response systems, web-based DICOM viewers, and collaborative platforms can enhance interactivity and simulate clinical practice effectively in the hybrid format. Creating an effective learning environment requires careful attention to establishing expectations, maintaining psychological safety, and ensuring equal participation between in-person and remote attendees. Active learning strategies, such as case-based discussions, buzz groups, and peer instruction, can be adapted to include both remote and in-person learners effectively.</p><p><strong>Conclusion: </strong>While the flexibility of hybrid education offers advantages for work-life balance and accessibility, maintaining educational quality requires thoughtful implementation of these strategies. As hybrid conferences become a permanent fixture in radiology education, programs must address these challenges to optimize the learning experience for all participants while preserving the essential elements of traditional radiology training.</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":"143441780","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":"Subspecialty training in pediatric musculoskeletal imaging: an innovative approach to outreach, collaboration, and faculty development.","authors":"Mohammad Jalloul, Maria Alejandra Bedoya, Ramon Sanchez-Jacob, Monica Galeano, Clara Anoni, Madelon Gonzalez, Hamza Alizai, Abass Noor, Hansel J Otero","doi":"10.1007/s00247-025-06191-9","DOIUrl":"https://doi.org/10.1007/s00247-025-06191-9","url":null,"abstract":"","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":"143441763","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":"Two-year experience of radiation dose watch for pediatric general fluoroscopic examinations.","authors":"Ronald A Yang, Kari Hayes, Sarah S Milla, Shannan Dieselberg, Wei Zhou","doi":"10.1007/s00247-025-06183-9","DOIUrl":"https://doi.org/10.1007/s00247-025-06183-9","url":null,"abstract":"<p><strong>Background: </strong>The radiation dose of pediatric general fluoroscopy exams has historically been a topic of concern, with ongoing efforts and significant progress made.</p><p><strong>Objective: </strong>The purpose of this study is to evaluate dose performance with a dose monitor program for pediatric general fluoroscopy.</p><p><strong>Materials and methods: </strong>Pediatric general fluoroscopy exams performed between April 1, 2020, and Dec. 31, 2022 were collected and monitored. For each exam, fluoroscopy time, dose-area-product (DAP), reference air kerma (RAK), and patient demographic information were analyzed. RAK, DAP, and fluoroscopy time were tested using Pearson's correlation methods for the three most frequently performed procedures. The influence of patient habitus on dose was studied using linear regression methods. Dose performance among radiologists was compared and so the Wilcoxon signed-rank test between radiologists with ≤ 5 years and > 5 years of experience post fellowship. A significance level of P<0.05 was used to determine statistical significance.</p><p><strong>Results: </strong>A total of 12,029 cases were analyzed and the median RAK values range from 0.10 mGy to 1.30 mGy. RAK demonstrated a stronger correlation with DAP (upper gastrointestinal (UGI), R=0.97; P<0.0001) than with fluoroscopy time (UGI, R=0.19; P<0.0001). RAK values were linearly correlated with patient weight (UGI, R=0.49; P<0.0001). A stable trend of median RAK values was observed across the studied time periods. Radiologists with ≤ 5 years' experience showed significantly lower (P<0.0001) RAK than those with > 5 years' experience.</p><p><strong>Conclusion: </strong>Variations of pediatric general fluoroscopy dose performance were observed when comparing with other investigations. This study demonstrated that both patient size and operator experience influence radiation output in general fluoroscopy, factors that should be considered for pediatric fluoroscopy procedures.</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":"143441781","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":"BCGitis and BCGosis spectrum of imaging findings in immunocompromised pediatric patients.","authors":"Latifah Alfahad, Ayman Khushaim, Waleed Alhabeeb, Abdullah Alzayed, Musab Almushayqih","doi":"10.1007/s00247-025-06182-w","DOIUrl":"https://doi.org/10.1007/s00247-025-06182-w","url":null,"abstract":"<p><p>Tuberculosis (TB) remains a significant public health concern despite preventive measures, such as the use of the Bacille Calmette-Guérin (BCG) vaccine, which reduces the risk and severity of early-life TB infection. The adverse effects of the BCG vaccine include infection by the live-attenuated organism, more commonly seen in the immunocompromised host. This pictorial review aims to outline the imaging spectrum of BCG-vaccine-related infections in immunocompromised pediatric patients, which can be localized (BCGitis) or disseminated (BCGosis). We illustrate the more common imaging findings, including lymphadenopathy and involvement of solid organs, as well as less frequently encountered sites, such as the lungs and gastrointestinal tract, emphasizing their distinct imaging patterns. Interpretation of these findings in the context of prior administration of the BCG vaccine not only helps in the diagnosis of BCG-vaccine-related infections and guiding timely management, but can also be an early indicator of an underlying immunodeficiency disorder, prompting comprehensive immunological investigation.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425905","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 training program for implementation of velopharyngeal MRI in the clinical setting.","authors":"Taylor D Snodgrass, Jamie L Perry, Thomas J Sitzman","doi":"10.1007/s00247-025-06186-6","DOIUrl":"https://doi.org/10.1007/s00247-025-06186-6","url":null,"abstract":"<p><strong>Background: </strong>Many craniofacial teams are interested in using velopharyngeal magnetic resonance imaging (MRI) clinically for surgical planning for management of velopharyngeal insufficiency (VPI). However, many teams report training and resources are barriers that prevent them from implementing MRI.</p><p><strong>Objective: </strong>(1) To describe a training program for implementation of velopharyngeal magnetic resonance imaging (MRI) in the clinical setting, (2) to assess the effectiveness of the training program, and (3) to identify factors associated with successful implementation of velopharyngeal MRI.</p><p><strong>Materials and methods: </strong>Eleven metropolitan-based hospitals with craniofacial clinics participated in a prospective observational study. From these 11 hospitals, 53 patients with VPI completed a velopharyngeal MRI aged 3 to 21 years in pediatric hospital settings. A training program was created and modified while launching velopharyngeal MRI at each hospital. The main outcome measures were (1) overall success rate of velopharyngeal MRI, (2) number of MRIs to achieve competence, and (3) success rate with velopharyngeal MRI after achieving competence.</p><p><strong>Results: </strong>Ten of the 11 hospitals achieved competence. The overall success rate was 81% (43/53), which improved to 89% after hospitals achieved competence (33/37). It took hospitals an average of 1.5 MRI scans to achieve competence (range 1-3 MRI scans). Factors associated with successful implementation of velopharyngeal MRI were having a speech-language pathologist present for the MRI, having consistent MRI staff, having previous experience with velopharyngeal MRI, and the use of video conferencing during MRI collection.</p><p><strong>Conclusions: </strong>The training program led to successful implementation of velopharyngeal MRI. Hospitals benefited from having resources that were friendly to use during real-time data collection. The use of consistent MRI staff, speech-language pathologists, or doing video conferencing with someone with experience implementing velopharyngeal MRI may improve velopharyngeal MRI scan success.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425908","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":"MRI assessment of velopharyngeal dysfunction: A comprehensive primer for radiologists.","authors":"Molly F MacIsaac, Samer L Elsamna, Javier F Quintana, S Alex Rottgers, Jordan N Halsey","doi":"10.1007/s00247-025-06180-y","DOIUrl":"https://doi.org/10.1007/s00247-025-06180-y","url":null,"abstract":"<p><p>Velopharyngeal dysfunction (VPD) is a condition where the velopharyngeal mechanism fails to close properly, resulting in nasal air escape during speech and hypernasal resonance. VPD is common in patients with cleft palate and presents significant challenges, often necessitating advanced imaging techniques for surgical treatment planning. Recent advancements in magnetic resonance imaging (MRI) have enhanced the capability to obtain detailed static images of velopharyngeal structures at rest and during sustained phonation, which are comparable or superior to traditional technologies. MRI is particularly effective at assessing the levator veli palatini muscle, a critical component of the velopharyngeal mechanism. As a non-invasive, radiation-free imaging method with high-resolution capabilities, MRI is becoming increasingly popular for VPD evaluation, especially in the pediatric population. However, understanding the complexities of VPD requires specialized knowledge spanning craniofacial surgery and speech-language pathology, which is often inaccessible in the radiology literature. While technical guides on MRI protocols for VPD exist, foundational knowledge of the velopharyngeal mechanism and its relevance to cleft anatomy remains underrepresented. This primer aims to bridge the gap between radiology and the complex multidisciplinary care of VPD by equipping radiologists with the knowledge necessary to effectively interpret MRI findings and integrate them into diagnostic and therapeutic pathways. By reviewing velopharyngeal and cleft anatomy, relevant VPD terminology, the principles of surgical management, and the role of MRI in velopharyngeal assessment, this paper provides radiologists with the context and tools to collaborate and communicate more effectively with cleft and craniofacial teams that treat this condition.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425929","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":"Endovascular management of acute portal vein thrombosis in pediatric liver transplant recipients less than 20 kg.","authors":"Sulaiman Karim, Xavior Jefferson, Nicolas Moreno, Ashley Upton, Alex Chau, Alberto Hernandez","doi":"10.1007/s00247-025-06189-3","DOIUrl":"https://doi.org/10.1007/s00247-025-06189-3","url":null,"abstract":"<p><strong>Background: </strong>Pediatric recipients of orthotopic liver transplants are at risk for post-transplant complications, particularly acute portal vein thrombosis, which jeopardizes patient survival and graft function. The incidence and impact of portal vein thrombosis are more severe in children compared to adults, with those under 5 most vulnerable to thrombotic events.</p><p><strong>Objective: </strong>This study aims to report our institutional experience with endovascular interventions for treating portal vein thrombosis in 11 pediatric liver transplant recipients who presented within 30-days post-transplant.</p><p><strong>Materials and methods: </strong>An IRB-approved retrospective review was conducted on pediatric patients (< 18 years of age) from a single tertiary care institution who received an orthotopic liver transplant and were diagnosed with acute (< 30 days) portal vein thrombosis, from July 2019 to April 2022. Patient demographics, procedural characteristics, and outcomes were recorded.</p><p><strong>Results: </strong>Eleven patients were treated with percutaneous recanalization at a median of 6-days post-transplant for portal vein thrombosis. Median age at the time of transplant was 1.1 years (range 0.64 to 2.14), weight of 8.7 kg (range 6.1 to 18.9 kg), and body mass index of 18.2 (range 14.5 to 21.9). Portal venous access was obtained via trans-hepatic (n = 6) or trans-splenic (n = 4), or both (n = 1) under ultrasound guidance. Mechanical thrombectomy (n = 3), balloon angioplasty (n = 11), and pulse-spray tPA (n = 3) were performed to restore flow to the portal system. Technical success was achieved in all cases (n = 11). The median reduction in portal venous pressure gradient was 10 mmHg (range 4 to 15). One-year primary patency was 70% (7/10), primary-assisted was 100% (1/1), and secondary patency was 100% (3/3). There were no immediate procedure-related complications.</p><p><strong>Conclusion: </strong>Acute post-transplant portal vein thrombosis is a significant complication following pediatric liver transplantation with high morbidity. In the early post-transplant period, endovascular interventions to restore portal flow are safe and can produce durable results.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425926","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":"MRI safety-developing the right culture.","authors":"Dana Alkhulaifat, Lorenna Vidal, Ethan Larsen, Suraj D Serai, Mario Sinti-Ycochea, Patricia Mecca, Lauren Orfe, Susan Sotardi","doi":"10.1007/s00247-025-06179-5","DOIUrl":"https://doi.org/10.1007/s00247-025-06179-5","url":null,"abstract":"<p><p>In recent years, magnetic resonance imaging (MRI) among pediatric populations has risen, requiring strict adherence to MRI safety protocols for patient care. Children often face more complex safety risks compared to adult populations due to several challenges, such as increased need for sedation, and the limited data and testing on implant safety in pediatric patients. Our aim is to examine the key features of MRI safety and how safety culture impacts important aspects of MRI processes, including patient and staff screening, physical barriers, zoning regulations, emergency response protocols, and adverse event management. This article also explores the cornerstone of MRI safety, the Just Culture approach, which emphasizes transparency, accountability, and improvement of processes over punishment. Key efforts towards building and maintaining safety culture focus on raising awareness, outlining escalation procedures, and instilling a safety-first mindset. Given MRI safety's critical importance in pediatric patient care and staff well-being, the development of a culture that supports these goals is an imperative for every imaging center.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425931","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":"In defense of the dyad - a commentary.","authors":"Nazia Husain, Deidra A Ansah, Andrada Popescu, Joshua D Robinson, Cynthia K Rigsby","doi":"10.1007/s00247-025-06174-w","DOIUrl":"https://doi.org/10.1007/s00247-025-06174-w","url":null,"abstract":"","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374544","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":"Ultrasound for midgut volvulus and malrotation: frequency and predictors of a non-diagnostic examination in a multi-institutional cohort.","authors":"Alexander Maad El-Ali, Desi M Schiess, Dane Van Tassel, Catalina Le Cacheux, Shailee V Lala, Monique Riemann, Jeffrey Tutman, Andrew C Sher, Marla B K Sammer, Oscar M Navarro, HaiThuy N Nguyen, Cicero T Silva","doi":"10.1007/s00247-024-06141-x","DOIUrl":"https://doi.org/10.1007/s00247-024-06141-x","url":null,"abstract":"<p><strong>Background: </strong>Ultrasound (US) is increasingly used as the first-line imaging modality for the diagnosis of midgut volvulus, but may be non-diagnostic in some cases.</p><p><strong>Objective: </strong>To determine the frequency and factors associated with non-diagnostic US for each midgut volvulus and malrotation in a multi-institutional sample.</p><p><strong>Materials and methods: </strong>We conducted a retrospective multi-institutional study of children (age 0-18 years) who underwent US to evaluate for midgut volvulus and malrotation between January 1, 2018, and June 30, 2021, and had an available reference standard of one of the following: upper GI series, CT/MRI, surgery, or, for volvulus, clinical follow-up at 30 days or greater. Blinded review of US images was performed by a single radiologist at each institution. When available, radiographs acquired ≤3 h from the US were reviewed for bowel gas pattern. After blinded review, original ultrasound reports were classified as diagnostic or non-diagnostic for midgut volvulus and malrotation. Stepwise logistic regression identified the most important predictors of non-diagnostic US.</p><p><strong>Results: </strong>In total, 637 patients were imaged for midgut volvulus and 311 for malrotation. Based on original report review, non-diagnostic proportions of examinations for volvulus and malrotation were 13.5% (86/637) and 25.7% (80/311), respectively. Based on blinded review, non-diagnostic proportions of examinations for volvulus and malrotation were 17.3% (110/637) and 37.6% (117/311), respectively. Of the patients with US considered non-diagnostic for volvulus by original reports, 2.3% (2/86) were subsequently found to have volvulus. Among patients with non-diagnostic US for volvulus by blinded review (n=110), none was found to have volvulus. Gaseous dilation with elongation of bowel on radiography was the single best predictor of a non-diagnostic US in blinded interpretation for volvulus and malrotation (OR=8.2 and 9.2; 95%CI 3.7-19.8 and 1.7-89.4, respectively) and in original radiology reports for volvulus (OR=4.5; 95%CI 2.2-9.5).</p><p><strong>Conclusion: </strong>A small fraction of a multi-institutional sample of US for midgut volvulus was non-diagnostic; however, assessment of malrotation without volvulus is associated with a higher frequency of non-diagnostic examinations. Dilated bowel gas pattern on radiography is the strongest predictor for a non-diagnostic US, although it does not necessarily preclude a diagnostic exam.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190029","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}