Deep medullary vein engorgement and superficial medullary vein engorgement: two patterns of perinatal venous stroke
AbstractPerinatal venous stroke has classically been attributed to cerebral sinovenous thrombosis with resultant congestion or thrombosis of the small veins draining the cerebrum. Advances in brain MRI, in particular susceptibility-weighted imaging, have enabled the visualization of the engorged small intracerebral veins, and the spectrum of perinatal venous stroke has expanded to include isolated congestion or thrombosis of the deep medullary veins and the superficial intracerebral veins. Congestion or thrombosis of the deep medullary veins or the superficial intracerebral veins can result in vasogenic edema, cytotoxic ed...
Source: Pediatric Radiology - October 22, 2020 Category: Radiology Source Type: research

Correction to: early life ionizing radiation exposure and cancer risks: systematic review and meta-analysis
The original version of Table 2 included two incorrect values. (Source: Pediatric Radiology)
Source: Pediatric Radiology - October 22, 2020 Category: Radiology Source Type: research

Overview of chest involvement at computed tomography in children with coronavirus disease 2019 (COVID-19)
ConclusionSymptoms associated with pulmonary involvement were most common in infants and young children. The lung lesions of most patients were absorbed and improved in about 9  days. (Source: Pediatric Radiology)
Source: Pediatric Radiology - October 21, 2020 Category: Radiology Source Type: research

Psychology and the enhancement of pediatric care
(Source: Pediatric Radiology)
Source: Pediatric Radiology - October 20, 2020 Category: Radiology Source Type: research

Quantitative T1 mapping of the normal brain from early infancy to adulthood
ConclusionRegardless of age, quantitative T1 mapping of the pediatric brain is feasible in clinical practice. Normal age-dependent values should contribute to improved discrimination of subtle intracerebral alterations. (Source: Pediatric Radiology)
Source: Pediatric Radiology - October 17, 2020 Category: Radiology Source Type: research

Computed tomography angiography for renal artery stenosis in children: a flip flop isn ’t always bad
(Source: Pediatric Radiology)
Source: Pediatric Radiology - October 17, 2020 Category: Radiology Source Type: research

Fetal brain small vessel disease 1 caused by a novel mutation in the COL4A1 gene
AbstractA singleton fetus was referred to fetal magnetic resonance imaging (MRI) at 25  weeks due to mild ventriculomegaly and an abnormal fetal echocardiogram showing cardiomegaly, right ventricular hypertrophy and tricuspid insufficiency. Patchy areas of ischemic infarction, extensive subacute and chronic hemorrhage not respecting vascular territories, encephaloclastic cysts and cl osed lip schizencephaly were identified. Cataract was detected postnatally. The anomalies were caused by a pathogenic mutation (c.353 G>A; p.G118D) in the COL4A1 gene. The phenotype seen in this case, i.e. small vessel cerebral di...
Source: Pediatric Radiology - October 15, 2020 Category: Radiology Source Type: research

Noninvasive imaging of pediatric pancreatitis: joint recommendations from the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition and the Society for Pediatric Radiology
(Source: Pediatric Radiology)
Source: Pediatric Radiology - October 15, 2020 Category: Radiology Source Type: research

DeepLiverNet: a deep transfer learning model for classifying liver stiffness using clinical and T2-weighted magnetic resonance imaging data in children and young adults
AbstractBackgroundAlthough MR elastography allows for quantitative evaluation of liver stiffness to assess chronic liver diseases, it has associated drawbacks related to additional scanning time, patient discomfort, and added costs.ObjectiveTo develop a machine learning model that can categorically classify the severity of liver stiffness using both anatomical T2-weighted MRI and clinical data for children and young adults with known or suspected pediatric chronic liver diseases.Materials and methodsWe included 273 subjects with known or suspected chronic liver disease. We extracted data including axial T2-weighted fast sp...
Source: Pediatric Radiology - October 13, 2020 Category: Radiology Source Type: research

Clinical utilization of whole-body PET/MRI in childhood sarcoma
AbstractHybrid positron emission tomography (PET)/magnetic resonance imaging (MRI) has emerged as a useful tool that combines the superior tissue contrast of MRI with the targeted functional imaging of PET. In the assessment of sarcomas in children, PET/MRI has the potential to serve as a single point of service, allowing superior anatomical imaging and evaluation of metabolic uptake during one imaging session. In this pictorial essay, we review our preliminary experience with PET/MRI in the evaluation of pediatric sarcoma. The limitations and contraindications of PET/MRI are also discussed. (Source: Pediatric Radiology)
Source: Pediatric Radiology - October 11, 2020 Category: Radiology Source Type: research

Assistant editor transitions: thank you, thank you, thank you (and welcome ×3!)
(Source: Pediatric Radiology)
Source: Pediatric Radiology - October 10, 2020 Category: Radiology Source Type: research

Severe COVID-19 initially presenting as mesenteric adenopathy
We report a case of COVID-19 in a healthy teenager who initially presented with isolated mesenteric adenopathy, typically a self-limited illness, which progressed to severe illness requiring intensive care before complete recovery. The boy tested negative for COVID-19 twice by polymerase chain reaction (PCR) from upper respiratory swabs before sputum PCR resulted positive. A high index of suspicion should be maintained for COVID-19 given the continued emergence of new manifestations of the disease. (Source: Pediatric Radiology)
Source: Pediatric Radiology - October 10, 2020 Category: Radiology Source Type: research

Hepatic magnetic resonance T1-mapping and extracellular volume fraction compared to shear-wave elastography in pediatric Fontan-associated liver disease
AbstractBackgroundChildren with Fontan circulation are at risk of developing hepatic fibrosis/cirrhosis. Reliable noninvasive monitoring techniques are lacking or under development.ObjectiveTo investigate surrogate indicators of hepatic fibrosis in adolescents with Fontan circulation by evaluating hepatic magnetic resonance (MR) T1 mapping and extracellular volume fraction measurements compared to US shear-wave elastography.Materials and methodsWe analyzed hepatic native T1 times and extracellular volume fractions with modified Look-Locker inversion recovery. Liver stiffness was analyzed with shear-wave elastography. We co...
Source: Pediatric Radiology - October 9, 2020 Category: Radiology Source Type: research

Chronic nonbacterial osteomyelitis — clinical and magnetic resonance imaging features
ConclusionNearly one-fourth of the children presented with isolated back pain, particularly girls. The most common sites of disease were the femur, tibia and pelvic bones. Increased inflammatory markers seem to predict the number of MRI sites involved. (Source: Pediatric Radiology)
Source: Pediatric Radiology - October 9, 2020 Category: Radiology Source Type: research

Utility of sonography for identifying metastatic cervical adenopathy in children with differentiated thyroid carcinoma at presentation
ConclusionSonography has a high accuracy, specificity and PPV for identifying metastatic cervical lymph node involvement in children with differentiated thyroid carcinoma at presentation. Most of the abnormal lymph nodes were round in shape and had abnormal echogenicity and vascularity. Importantly, this paper emphasizes that in children, nodes with histologically proven metastases from differentiated thyroid carcinoma can be normal in size and shape. In these patients the presence of metastatic involvement might be recognized sonographically only on the basis of abnormal echogenicity and vascularity. (Source: Pediatric Radiology)
Source: Pediatric Radiology - October 8, 2020 Category: Radiology Source Type: research

Imaging appearance of ticks in tick paralysis
(Source: Pediatric Radiology)
Source: Pediatric Radiology - October 8, 2020 Category: Radiology Source Type: research

Superficial anatomy of the neonatal cerebrum — an ultrasonographic roadmap
AbstractNeurosonography is an essential imaging modality for assessing the neonatal brain, particularly as a screening tool to evaluate intracranial hemorrhage, hydrocephalus and periventricular leukomalacia. The primary advantages of neurosonography include portability, accessibility and lack of ionizing radiation. Its main limitations are intrinsic operator dependence and the need for an open fontanelle. Neurosonographic imaging acquisition is typically performed by placing a sector transducer over the anterior fontanelle and following sagittal and coronal sweeps. The sensitivity of neurosonography has markedly improved ...
Source: Pediatric Radiology - October 6, 2020 Category: Radiology Source Type: research

Imaging of Horner syndrome in pediatrics: association with neuroblastoma
AbstractNeuroblastoma is the most common neoplasm associated with pediatric Horner syndrome. The laboratory and imaging evaluation of isolated pediatric Horner syndrome is controversial. We review the literature published in the last several decades and present the rationale for the imaging work-up in this patient cohort. (Source: Pediatric Radiology)
Source: Pediatric Radiology - October 5, 2020 Category: Radiology Source Type: research

Ligamentum arteriosum calcification on paediatric postmortem computed tomography
ConclusionIn the postmortem setting, ligamentum arteriosum calcification is a common finding in children  
Source: Pediatric Radiology - October 5, 2020 Category: Radiology Source Type: research

The role of child life in pediatric radiology
AbstractPediatric radiology departments rely heavily on a dedicated, efficient and collaborative multi-disciplinary health care team to provide efficient service and quality care to patients and families. Certified child life specialists are an essential part of this multi-disciplinary team. The main goal of the child life specialists is to improve the overall experience for patients and families. In addition, child life specialists, working in collaboration with the medical care team, help decrease the need for general anesthesia by providing patient pain management, distraction and coping techniques. These interventions ...
Source: Pediatric Radiology - September 16, 2020 Category: Radiology Source Type: research

Using informatics to engage patients
We present these initiatives, corresponding to each aspect of the radiology value stream, from the patient’s point of view. (Source: Pediatric Radiology)
Source: Pediatric Radiology - September 16, 2020 Category: Radiology Source Type: research

Engaging patients and families in pediatric radiology
AbstractWhile patient and family-centered care (PFCC) is currently a hot topic in medicine, it has long been a specific focus of pediatrics. The concept of PFCC includes a change in culture where physicians and patients move away from paternalism and instead view patients and families as partners in care. Although there are many ways in which adult-focused radiologists can learn from pediatric radiologists as leaders in PFCC, there remain many opportunities for improvement for all radiologists. (Source: Pediatric Radiology)
Source: Pediatric Radiology - September 16, 2020 Category: Radiology Source Type: research

Hermes
(Source: Pediatric Radiology)
Source: Pediatric Radiology - September 16, 2020 Category: Radiology Source Type: research

Innovations for improving the patient experience in pediatric radiology
(Source: Pediatric Radiology)
Source: Pediatric Radiology - September 16, 2020 Category: Radiology Source Type: research

Early life ionizing radiation exposure and cancer risks: systematic review and meta-analysis
ConclusionCT exposure in childhood appears to be associated with increased risk of cancer while no significant association was observed with diagnostic radiographs. (Source: Pediatric Radiology)
Source: Pediatric Radiology - September 9, 2020 Category: Radiology Source Type: research

Pediatric Radiology Continuing Medical Education Activity
(Source: Pediatric Radiology)
Source: Pediatric Radiology - September 9, 2020 Category: Radiology Source Type: research

Pediatric appendiceal ultrasound: maintaining accuracy, increasing determinacy and improving clinical outcomes following the introduction of a standardized reporting template
AbstractBackgroundPediatric patients who underwent appendiceal US and received an equivocal interpretation had poorer clinical outcomes and higher medical costs compared to those to whom a definitive interpretation was given, either positive or negative. In an effort to reduce equivocal interpretations, we educated our group on the importance of increasing determinacy and encouraged the use of a reporting template with a definitive impression.ObjectiveWe hypothesized that educational sessions and implementation of an optional reporting template with only a definitive impression would reduce equivocal reporting and improve ...
Source: Pediatric Radiology - September 8, 2020 Category: Radiology Source Type: research

Pediatric lung ultrasound: reply to Corsini et al.
(Source: Pediatric Radiology)
Source: Pediatric Radiology - September 8, 2020 Category: Radiology Source Type: research

Quantitative characterization of extraocular orbital lesions in children using diffusion-weighted imaging
This study aimed to evaluate the use of DWI and apparent diffusion coefficient (ADC) values to differentiate between benign and malignant extraocular orbital lesions in children.Materials and methodsThis retrospective study included 73 patients under the age of 18 seen in our hospital between October 2016 and February 2019. The extraocular orbital lesions were evaluated clinically and radiologically using DWI. The diagnosis was confirmed by either histological examination (after biopsy or surgery) or based on clinical and radiologic evaluation.ResultsThe malignant lesions were found to have increased diffusion restriction ...
Source: Pediatric Radiology - September 7, 2020 Category: Radiology Source Type: research

Quantitative magnetic resonance imaging for determining bone marrow fat fraction at 1.5  T and 3.0 T: a technique to noninvasively assess cellularity and potential malignancy of the bone marrow
AbstractBackgroundPediatric bone marrow assessment by MRI is challenging and primarily experiential and qualitative, with a paucity of clinically useful quantitative imaging techniques.ObjectiveMRI fat fraction (MRI-FF) is a technique used to quantify the degree of fat in other organ systems. The purpose of this study was to assess whether MRI-FF accurately measures bone marrow composition.Materials and methodsThis two-part study included a validation phase, followed by an application phase. For the validation phase, the MRI-FF of piglet bones (6 long bones, 8 axial bones) was performed at 1.5  tesla (T) and 3.0 ...
Source: Pediatric Radiology - September 4, 2020 Category: Radiology Source Type: research

Virtual endoluminal aortic root views determined at coronary CT angiography — an important tool for improving anomalous coronary artery visualization and surgical planning
AbstractAnomalous origin of the coronary arteries, though uncommon, is of great clinical concern. It can be the cause of sudden cardiac death and abnormal cardiac hemodynamics. Advances in electrocardiographically (ECG)-gated multi-detector CT have increased diagnostic accuracy in detecting anomalous origin of coronary arteries and their interarterial and intramural courses. Recent advances in multi-detector CT image processing software have allowed the creation of virtual endoluminal views of the aortic root and improved assessment of the intramural course (the length and relationship to the intercoronary commissure) of t...
Source: Pediatric Radiology - September 4, 2020 Category: Radiology Source Type: research

Central venous catheter fracture leading to TPN extravasation and abdominal compartment syndrome diagnosed with bedside contrast-enhanced ultrasound
We present a case utilizing contrast-enhanced ultrasound (CEUS) at the bedside to assess catheter integrity in a critically ill infant with a large intra-abdominal fluid collection. CEUS demonstrated extravasation into the collection, confirming catheter fracture and prompting immediate cessation of line use and recommendation for exchange. This case shows the utility of CEUS to evaluate central venous access devices in children who are unable to travel to interventional radiology for a standard contrast injection. (Source: Pediatric Radiology)
Source: Pediatric Radiology - September 4, 2020 Category: Radiology Source Type: research

Can lessons from the COVID-19 pandemic help define a strategy for global pediatric radiology education?
(Source: Pediatric Radiology)
Source: Pediatric Radiology - September 4, 2020 Category: Radiology Source Type: research

Ultrasonography in pediatric Budd –Chiari syndrome
AbstractBudd –Chiari syndrome is a vascular pathology of the liver, commonly seen in adults and uncommon in children. Most children with Budd–Chiari syndrome present with ascites, and an etiology is found in only about 50%. Ultrasonography (US) with color Doppler is the main modality used in the diagnosis. U S imaging additionally guides radiologic interventions and follow-up after recanalization or shunt procedure. In this pictorial review, we illustrate the findings in pediatric Budd–Chiari syndrome as seen on B-mode and color Doppler US and describe the role of US in guiding percutaneous radiologic int...
Source: Pediatric Radiology - August 31, 2020 Category: Radiology Source Type: research

Diffusion tensor imaging in frontostriatal tracts is associated with executive functioning in very preterm children at 9  years of age
AbstractBackgroundVery preterm birth can disturb brain maturation and subject these high-risk children to neurocognitive difficulties later.ObjectiveThe aim of the study was to evaluate the impact of prematurity on microstructure of frontostriatal tracts in children with no severe neurologic impairment, and to study whether the diffusion tensor imaging metrics of frontostriatal tracts correlate to executive functioning.Materials and methodsThe prospective cohort study comprised 54 very preterm children (mean gestational age 28.8  weeks) and 20 age- and gender-matched term children. None of the children had severe neur...
Source: Pediatric Radiology - August 31, 2020 Category: Radiology Source Type: research

Quantitative contrast-enhanced ultrasound of the brain on twin fetal lambs maintained by the extrauterine environment for neonatal development (EXTEND): initial experience
ConclusionIn this preliminary experience, we show that CEUS of the brain is feasible in fetal lambs maintained on the EXTEND system and that changes in perfusion can be quantified, which is promising for the application of CEUS in this extrauterine system supporting the premature infant. (Source: Pediatric Radiology)
Source: Pediatric Radiology - August 31, 2020 Category: Radiology Source Type: research

Lung ultrasound in pediatric patients: the clinician ’s point of view
(Source: Pediatric Radiology)
Source: Pediatric Radiology - August 31, 2020 Category: Radiology Source Type: research

Three-dimensional magnetic resonance imaging ultrashort echo-time cones for assessing lung density in pediatric patients
ConclusionSignal intensity of lung on ultrashort echo-time is higher than that on fast spin-echo sequences, is age-dependent and shows a gravity-dependent anterior to posterior gradient. This signal variation appears similar to lung density described on CT. (Source: Pediatric Radiology)
Source: Pediatric Radiology - August 28, 2020 Category: Radiology Source Type: research

A model of professionalism: Eugene Klatte, MD
(Source: Pediatric Radiology)
Source: Pediatric Radiology - August 28, 2020 Category: Radiology Source Type: research

Dual-energy X-ray absorptiometry bone densitometry in pediatrics: a practical review and update
AbstractThe assessment of pediatric bone mineral content and density is an evolving field. In this manuscript we provide a practical review and update on the interpretation of dual-energy X-ray absorptiometry (DXA) in pediatrics including historical perspectives as well as a discussion of the recently published 2019 Official Position Statements of the International Society of Clinical Densitometry (ISCD) that apply to children. (Source: Pediatric Radiology)
Source: Pediatric Radiology - August 27, 2020 Category: Radiology Source Type: research

Magnetic resonance imaging evaluation of osteoid osteoma: utility of the dark rim sign
In this study, we assessed the presence of a novel dark rim sign and its utility in the MRI diagnosis of osteoid osteoma.ObjectiveThe purpose of this retrospective study was to assess the utility of the dark rim sign seen on MRI in children with osteoid osteoma.Materials and methodsMRI studies from 36 pediatric patients with osteoid osteoma and a control group of patients with either osteomyelitis or stress fracture were analyzed and then compared for the presence of the dark rim sign. Patients from the osteoid osteoma group were further divided based on nidus location and evaluated for the presence of the dark rim sign.Re...
Source: Pediatric Radiology - August 25, 2020 Category: Radiology Source Type: research

Performance of simultaneous multi-slice accelerated diffusion-weighted imaging for assessing focal renal lesions in pediatric patients with tuberous sclerosis complex
ConclusionA 55% reduction in scan time was achieved using simultaneous multi-slice DWI for abdominal imaging in children with TSC, with near identical image quality as standard DWI. These results suggest that multi-slice techniques should be considered more broadly as an MRI acceleration technique in children. (Source: Pediatric Radiology)
Source: Pediatric Radiology - August 25, 2020 Category: Radiology Source Type: research

Initial experience with contrast-enhanced ultrasound in the first week after liver transplantation in children: a useful adjunct to Doppler ultrasound
AbstractBackgroundDoppler US is the primary screening for post-liver transplant vascular complications, but indeterminate findings require further imaging.ObjectiveTo evaluate whether contrast-enhanced US improves diagnostic assessment of vascular complications suspected by Doppler US.Materials and methodsWe retrospectively reviewed Doppler US and contrast-enhanced US studies obtained in the first week following liver transplant. Doppler US was performed twice daily for the first 5 postoperative days, and CEUS in the first postoperative day and when vascular complications were suspected. We correlated Doppler US and CEUS w...
Source: Pediatric Radiology - August 22, 2020 Category: Radiology Source Type: research

After the initial COVID-19 surge: a phased radiology departmental re-opening plan
(Source: Pediatric Radiology)
Source: Pediatric Radiology - August 21, 2020 Category: Radiology Source Type: research

Inspiring physician –advocates: Frederick Douglass’s voice
(Source: Pediatric Radiology)
Source: Pediatric Radiology - August 21, 2020 Category: Radiology Source Type: research

Lung ultrasound findings in pediatric community-acquired pneumonia requiring surgical procedures: a two-center prospective study
ConclusionLarger consolidations, larger and more complicated pleural effusions, and liquid and air bronchograms were associated with surgical treatment. (Source: Pediatric Radiology)
Source: Pediatric Radiology - August 20, 2020 Category: Radiology Source Type: research

A pandemic offers a silver lining for pediatric radiology training
(Source: Pediatric Radiology)
Source: Pediatric Radiology - August 20, 2020 Category: Radiology Source Type: research

'Modification of chest radiography exposure parameters using a neonatal chest phantom': reply to Schneider
(Source: Pediatric Radiology)
Source: Pediatric Radiology - August 20, 2020 Category: Radiology Source Type: research

The long and winding career path: lessons learned
(Source: Pediatric Radiology)
Source: Pediatric Radiology - August 20, 2020 Category: Radiology Source Type: research

Correction to: imaging of complications following Fontan circulation in children —diagnosis and surveillance
In the original version of this paper there was an inadvertent misnumbering of references. (Source: Pediatric Radiology)
Source: Pediatric Radiology - August 19, 2020 Category: Radiology Source Type: research