Journal of pediatric neuroradiology最新文献

{"title":"Computed Tomography in Pediatric Traumatic Brain Injury: Who Needs It and How Is It Scored?","authors":"L. Eisenmenger, Y. Anzai","doi":"10.1055/s-0036-1584243","DOIUrl":"https://doi.org/10.1055/s-0036-1584243","url":null,"abstract":"Abstract Head trauma is one of the most common reasons for children to visit the emergency room in the United States. Computed tomography (CT) utilization for pediatric head trauma continues to increase despite public concern regarding ionizing radiation exposure. More than 90% of the imaging studies in children with minor head trauma are negative for traumatic brain injuries (TBIs). Judicious use of head CT is important to reduce unnecessary ionizing radiation in the vulnerable pediatric population. With the goal of reducing unnecessary CT for pediatric TBI patients, an important question is not “who needs head CT” but “who can safety avoid head CT.” When abnormal CT findings are present for moderate or severe TBI patients, accurate and reproducible scoring systems are also necessary to make CT reports actionable and meaningful for physicians in the trauma team. This article outlines the current evidence-based practices for pediatric head CT use, highlighting relevant clinical decision-making tools, as well as reviews the current CT-based trauma scoring systems.","PeriodicalId":89989,"journal":{"name":"Journal of pediatric neuroradiology","volume":"78 1","pages":"013 - 019"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81271216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Neuroimaging in the Diagnosis, Treatment, and Prognosis of Traumatic Brain Injury in Children","authors":"S. Murphy, A. Duhaime","doi":"10.1055/s-0036-1584226","DOIUrl":"https://doi.org/10.1055/s-0036-1584226","url":null,"abstract":"Abstract Neuroimaging is a central pillar in the diagnosis, management, prognostication, and research of pediatric traumatic brain injury (TBI). Head computed tomography (CT) is the most readily available and rapid method of acute neuroimaging in emergency departments and it has been viewed as the diagnostic standard. However, concern about excessive and unnecessary radiation exposure in children has led to the development of clinical prediction rules with a goal of limiting excessive CT imaging in children with blunt head trauma. There is a trend toward increased use of structural magnetic resonance imaging (MRI) including tailored rapid techniques, in both acute and follow-up imaging in children. Where available, MRI is more sensitive for parenchymal injury than CT and may fulfill the dual goal of decreasing radiation exposure and increasing the yield of more subtle parenchymal trauma. In the current era of TBI management, the diagnosis and treatment of TBI is driven increasingly by neuroimaging. The ability of neuroimaging to provide multidimensional information, specifically, pathoanatomic classification of injuries, as well as important data on injury evolution over time, is increasingly relied upon to match appropriate treatments to the pathophysiology specific to a given injury profile. When combined with premorbid, acute clinical, biomarker, and genetic data, the hope is that multidimensional characterization of injury will improve current management of children with TBIs as well as stratify patients more effectively for clinical trials in the future.","PeriodicalId":89989,"journal":{"name":"Journal of pediatric neuroradiology","volume":"10 1","pages":"002 - 006"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90424519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Traumatic Brain Injury: Common Data Elements to Inform Diagnosis, Neuroimaging, and Outcome Metrics","authors":"C. Filippi, P. Sanelli","doi":"10.1055/s-0036-1584416","DOIUrl":"https://doi.org/10.1055/s-0036-1584416","url":null,"abstract":"Abstract Currently, it is difficult for clinicians to reach consensus on best practices for the treatment and management of mild traumatic brain injury (mTBI) in children because of the paucity and quality of existing scientific evidence. Most studies of mTBI, or concussion in pediatric patients are limited by small sample sizes, retrospective study design, and lack of standardization with regard to computed tomography (CT) and magnetic resonance imaging (MRI) protocols, clinical assessments, outcome metrics, treatment management, and even definitions of mTBI and clinical severity. Common data elements (CDEs) is an initiative of the National Institute of Health (NIH) to standardize data acquisition, data collection, definitions, and outcome metrics in pediatric mTBI. CDEs might make it easier to compare research studies performed at different institutions in different settings, so that consensus recommendations can be achieved. The purpose of this review is to inform neuroradiologists about the development of CDEs for pediatric mTBI, which can inform longitudinal, prospective studies that will provide the data for much needed evidence-based guidelines in the management of pediatric mTBI.","PeriodicalId":89989,"journal":{"name":"Journal of pediatric neuroradiology","volume":"445 1","pages":"032 - 037"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78258695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benign Orbital Lesions","authors":"A. Pollock, K. Shekdar, T. Feygin","doi":"10.1055/s-0036-1584417","DOIUrl":"https://doi.org/10.1055/s-0036-1584417","url":null,"abstract":"Abstract Benign orbital lesions comprise a wide spectrum of pathologies that greatly differ in their nature, originating from different orbital tissues. In this review paper, we describe the most commonly encountered orbital diseases in children, such as congenital, inflammatory, and infectious disorders. We also describe a variety of vascular lesions, including benign neoplasms, and malformations as well as other various benign neoplastic soft tissue and osseous lesions. We focus on the appropriate choice of imaging modalities for each entity.","PeriodicalId":89989,"journal":{"name":"Journal of pediatric neuroradiology","volume":"26 1","pages":"097 - 115"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73333605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in Imaging of Ocular and Orbital Tumors in Children","authors":"T. Feygin","doi":"10.1055/s-0036-1584134","DOIUrl":"https://doi.org/10.1055/s-0036-1584134","url":null,"abstract":"This issue of the Journal of Pediatric Neuroradiology is dedicated to orbital imaging in children. Each article in the journal will describe common and uncommon imaging features of a variety of orbital disorders in children. Presently, many congenital orbital lesions may be diagnosed prenatally. It certainly makes it necessary for pediatric radiologists and neuroradiologists to be aware of the appearance of these lesions on fetal imaging. Therefore, the first article of this issue demonstrates normal fetal orbital anatomy, describes the growing spectrum of recognizable fetal orbital pathology, and discusses currently available prenatal imaging (►Fig. 1). Other articles within this issue describe benign and malignant disorders of the orbits, diseases of the globe, and advances in imaging of optic pathway glioma. Imaging plays an important role in evaluation of orbital disease. To make the correct diagnosis of orbital lesions may be difficult for several reasons. It may be challenging to obtain in children an accurate history and physical examination. The presenting symptoms (and imaging findings) of different pathologic entities in the orbits may overlap considerably. Nonneoplastic orbital masses may present in a dramatic fashion with visual loss and destructive changes of the orbit, raising concerns for malignancy. At the same time, some malignant tumors of the orbit may closely resemble inflammatory cellulitis both clinically and on imaging. Some of the orbital lesions have a high association with systemic and genetic disorders and, in these cases, represent just the “tip of the iceberg.” Diagnosis of the orbital lesion may prompt diligent search of concurrent lesions elsewhere in the body. There have been great clinical advancements in treatment of malignant orbital lesions, and therefore, many patients live longer. As a result of the prolongation of the patient’s life, several new patterns of progressed/recurrent disease and new types of treatment complications have been revealed. Orbital imaging made tremendous progress in the last decade aswell. New imagingmodalities and newapplications of existing technologies havebeen developed and successfully implemented in clinical practice. Proper utilization of primary imaging modalities is discussed in each article: ultrasonography (echography), computed tomography (CT), magnetic resonance imaging, positron emission tomography, and, in select cases, conventional angiography. Furthermore, several emerging and well-established advanced imaging techniques are emphasized where appropriate. Implementation of spiral CT allows for presurgical evaluation of orbital Fig. 1. Three-dimensional fetal ultrasound shows normal fetal face with open eyes.","PeriodicalId":89989,"journal":{"name":"Journal of pediatric neuroradiology","volume":"80 1","pages":"068 - 069"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86212098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retinoblastoma: Advanced Imaging, Clinical Approach","authors":"T. Feygin, A. Leahey","doi":"10.1055/s-0036-1584135","DOIUrl":"https://doi.org/10.1055/s-0036-1584135","url":null,"abstract":"Abstract Retinoblastoma (RB) is a malignant tumor of the retina and the most common intraocular pediatric tumor. It typically affects children younger than 4 years of age. Loss or mutation of RB genes causes absence of RB control protein and subsequent uncontrolled cell division and tumor growth. In this review article, we describe how two forms of RB—germline (40%) and somatic sporadic (60%)—differ in their clinical presentation and prognosis. The accurate diagnosis, staging, and monitoring of the disease may be achieved with a combination of ophthalmologic examination, genetic analysis, and modern imaging. We refer to a spectrum of clinical and imaging modalities, which may be used in the diagnosis of RB. The advantages and shortcomings of ocular ultrasound, orbital computed tomography, and magnetic resonance imaging (MRI) are described. Modern imaging protocols allow for better assessment of disease extension and can help make treatment decisions for eye-sparing procedures in some cases to avoid enucleation. Essential components of optimal orbital MRI are emphasized. The roles of various MRI sequences are highlighted for demonstration of original tumor morphology and extension, and for the accurate assessment of disease progression and response of RB to treatment on follow-up examinations. Imaging features of aggressive or advanced disease and normal appearance of posttreatment eye and posttreatment complications are also illustrated.","PeriodicalId":89989,"journal":{"name":"Journal of pediatric neuroradiology","volume":"1 1","pages":"082 - 096"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82776468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malignant Orbital Lesions in Children","authors":"H. Dahmoush, T. Feygin","doi":"10.1055/s-0036-1584284","DOIUrl":"https://doi.org/10.1055/s-0036-1584284","url":null,"abstract":"Abstract This review paper is dedicated to imaging of malignant orbital lesions in children. We reviewed pediatric primary malignant orbital lesions and metastatic disease from a known distant primary malignancy. The imaging features and clinical presentation of extraocular malignant masses are often nonspecific and overlap with each other and with benign lesions. We emphasized common and uncommon characteristics of malignant orbital masses and described the advantages and shortcomings of available imaging modalities.","PeriodicalId":89989,"journal":{"name":"Journal of pediatric neuroradiology","volume":"8 1","pages":"116 - 131"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82027704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced Magnetic Resonance Imaging in Optic Pathway Gliomas","authors":"P. de Blank, S. Ellika, Michael J. Fisher","doi":"10.1055/s-0036-1584207","DOIUrl":"https://doi.org/10.1055/s-0036-1584207","url":null,"abstract":"Abstract Optic pathway gliomas (OPGs) are low-grade neoplasm of the precortical visual pathway commonly associated with neurofibromatosis type 1. Although these tumors rarely threaten life, up to half of affected children will undergo visual acuity loss that cannot be corrected with refractive lenses. Given the variability in clinical course and the importance of visual function in the treatment of OPG, advanced magnetic resonance (MR) techniques that help identify early vision loss or predict future dysfunction would be important in the management of OPG. In this article, we review the clinical features and management of OPGs and discuss recent advances in MR imaging (MRI) applicable to OPGs, including MR spectroscopy, diffusion-weighted imaging, diffusion tensor imaging, MR perfusion imaging, and MR fingerprinting. If these techniques can be used to help inform clinical decision making, MRI may provide a fast and noninvasive method to help guide clinical practice.","PeriodicalId":89989,"journal":{"name":"Journal of pediatric neuroradiology","volume":"2021 1","pages":"132 - 144"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84026634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging of Fetal Orbits","authors":"D. Mirsky, T. Feygin","doi":"10.1055/s-0036-1584225","DOIUrl":"https://doi.org/10.1055/s-0036-1584225","url":null,"abstract":"Abstract Abnormalities of the fetal orbit are occasionally visualized in the workup of suspected central nervous system malformation. It may be difficult to recognize orbital pathology in fetuses, especially when it is bilateral and symmetric. In this article, we at first addressed a normal appearance of the fetal orbits on prenatal imaging, which includes obstetric ultrasound and fetal magnetic resonance imaging. We also described a spectrum of lesions involving fetal eyes and orbits, including abnormal fetal orbital biometry, abnormal morphology of the vitreous and lens, and neoplastic and nonneoplastic masses of the orbits. Fetal orbital anomalies may be associated with a long list of underlying systemic disorders. For that reason, sometimes a particular orbital anomaly may be helpful as a denominator to narrow a diagnosis. Detection of fetal orbital lesions should prompt a diligent search for associated birth defects arising at the same time or sharing the same progenitor cell.","PeriodicalId":89989,"journal":{"name":"Journal of pediatric neuroradiology","volume":"115 15 1","pages":"070 - 081"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84184349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracranial Calcifications in the Pediatric Age Group: An Imaging Review","authors":"Anthony Dinizio, Jonathan K. Vincent, J. Nickerson","doi":"10.1055/s-0036-1583312","DOIUrl":"https://doi.org/10.1055/s-0036-1583312","url":null,"abstract":"Abstract Intracranial calcifications in the pediatric population are frequently encountered on imaging studies and may be seen in association with a variety of disease states. This review article provides an overview of the various pathological entities which may result in calcification on pediatric neuroimaging studies, including their key clinical, imaging, and histological features. For ease of discussion, disease categories are grouped into neoplastic, infectious, vascular, iatrogenic, and metabolic etiologies. The phakomatoses are discussed as well. It is hoped that the information contained in this review will assist the reader in formulating an appropriate differential diagnosis when intracranial calcifications are identified on imaging examinations.","PeriodicalId":89989,"journal":{"name":"Journal of pediatric neuroradiology","volume":"16 1","pages":"049 - 059"},"PeriodicalIF":0.0,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86145945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}