Intracranial calcifications in childhood: Part 2
This article is the second of a two-part series on intracranial calcification in childhood. In Part 1, the authors discussed the main differences between physiological and pathological intracranial calcification. They also outlined histological intracranial calcification characteristics and how these can be detected across different neuroimaging modalities. Part 1 emphasized the importance of age at presentation and intracranial calcification location and proposed a comprehensive neuroimaging approach toward the differential diagnosis of the causes of intracranial calcification. Pathological intracranial calcification can ...
Source: Pediatric Radiology - July 8, 2020 Category: Radiology Source Type: research

Operation of ultrasonography services in a dedicated paediatric hospital and a university hospital in Greece under the COVID-19 pandemic
AbstractUltrasonography (US) is one of the most common diagnostic imaging tests in children. During the coronavirus disease 2019 (COVID-19) pandemic, it is important to operate with a plan designed to protect health care workers, to prevent transmission of infection from child and parents to another child or an accompanying person in the US suite, and to save valuable protective material and resources. Measures during routine US in children can be challenging both in general hospitals with paediatric units and in dedicated paediatric hospitals. Special considerations include: a) cancellation or rescheduling of unnecessary ...
Source: Pediatric Radiology - July 7, 2020 Category: Radiology Source Type: research

A primer for pediatric radiologists on infection control in an era of COVID-19
AbstractPediatric radiology departments across the globe face unique challenges in the midst of the current COVID-19 pandemic that have not been addressed in professional guidelines. Providing a safe environment for personnel while continuing to deliver optimal care to patients is feasible when abiding by fundamental recommendations. In this article, we review current infection control practices across the multiple pediatric institutions represented on the Society for Pediatric Radiology (SPR) Quality and Safety committee. We discuss the routes of infectious transmission and appropriate transmission-based precautions, in a...
Source: Pediatric Radiology - July 7, 2020 Category: Radiology Source Type: research

Pediatric Radiology Continuing Medical Education Activity
(Source: Pediatric Radiology)
Source: Pediatric Radiology - July 7, 2020 Category: Radiology Source Type: research

Voiding urosonography and voiding cystourethrography in primary vesicoureteral reflux associated with mild prenatal hydronephrosis: a comparative study
ConclusionIn the absence of a reference standard, our results imply that voiding cystourethrography might underdiagnose reflux, and/or contrast-enhanced voiding urosonography may overdiagnose reflux. (Source: Pediatric Radiology)
Source: Pediatric Radiology - July 7, 2020 Category: Radiology Source Type: research

Solitary long-bone epiphyseal lesions in children: radiologic –pathological correlation and epidemiology
ConclusionThis study reports the relative frequency of pathology of pediatric solitary epiphyseal lesions and describes several features that might assist in differentiating between chondroblastoma and osteomyelitis. (Source: Pediatric Radiology)
Source: Pediatric Radiology - July 7, 2020 Category: Radiology Source Type: research

Role of high-resolution peripheral nerve magnetic resonance imaging in diagnosing median nerve tethering in a case of both-bone forearm fracture in a child
We present a case of median nerve tethering as a complication of both-bone forearm fracture in a child, with an emphasis on MRI as an appropriate and important complement to clinical and electrodiagnostic examination. Early intervention is essential because delayed surgical management of median nerve tethering can result in poor clinical outcomes as a result of irreversible muscle denervation. In this case, we highlight the importance of MRI to facilitate management, including early surgical intervention when appropriate, in median neuropathy following forearm fractures. (Source: Pediatric Radiology)
Source: Pediatric Radiology - July 3, 2020 Category: Radiology Source Type: research

Bilateral fibular fractures in a pre-ambulant infant
We report healing undisplaced fractures of both fibulae, in almost identical positions, in a pre-ambulant infant. The caregivers reported that the infant repeatedly banged his legs against the metal frame of his playpen. A video of this mechanism was provided to the instructed radiology expert and showed that the point of impact of the infant ’s legs against the metal frame was at a similar level to the radiographic abnormalities. This mechanism was therefore believed to be consistent with the injuries, resulting in a diagnosis of self-inflicted bilateral fibular fractures and not of inflicted injury. (Source: Pediatric Radiology)
Source: Pediatric Radiology - July 3, 2020 Category: Radiology Source Type: research

Revisiting gender workspace blind spots
(Source: Pediatric Radiology)
Source: Pediatric Radiology - July 3, 2020 Category: Radiology Source Type: research

Management strategies for children with COVID-19: ESPR practical recommendations
AbstractDuring the outbreak of the COVID-19 pandemic, guidelines have been issued by international, national and local authorities to address management and the need for preparedness. Children with COVID-19 differ from adults in that they are less often and less severely affected. Additional precautions required in the management of children address their increased radiosensitivity, need for accompanying carers, and methods for dealing with children in a mixed adult-paediatric institution. In this guidance document, our aim is to define a pragmatic strategy for imaging children with an emphasis on proven or suspected COVID...
Source: Pediatric Radiology - July 3, 2020 Category: Radiology Source Type: research

Neck CT angiography examinations for pediatric oropharyngeal trauma: diagnostic yield and proposal of a new targeted technique
ConclusionBased on low diagnostic yield and high radiation dose associated with standard neck CT angiography for evaluating oropharyngeal trauma, a targeted protocol is recommended, resulting in significantly less dose to the neck, while preserving diagnostic yield. (Source: Pediatric Radiology)
Source: Pediatric Radiology - July 3, 2020 Category: Radiology Source Type: research

High-resolution peripheral quantitative computed tomography in children with osteogenesis imperfecta
AbstractBone health in children with osteogenesis imperfecta is monitored using radiographs and dual-energy X-ray absorptiometry, which have limitations. High-resolution peripheral quantitative CT can non-invasively derive bone microarchitectural data. Children with severe osteogenesis imperfecta have fragile deformed bones, and positioning for this scan can be difficult. We assessed the feasibility of high-resolution peripheral quantitative CT in nine children aged 9 –15 years with osteogenesis imperfecta and compared results with dual-energy X-ray absorptiometry and with healthy controls. All nine recruited ch...
Source: Pediatric Radiology - July 1, 2020 Category: Radiology Source Type: research

Mixed-reality view of cardiac specimens: a new approach to understanding complex intracardiac congenital lesions
AbstractDigital reality is an emerging platform for three-dimensional representation of medical imaging data. In this technical innovation paper, the authors evaluated the accuracy and utility of mixed-reality technology in the morphological evaluation of complex congenital heart disease. The authors converted CT datasets of 12 heart specimens with different subtypes of double-outlet right ventricle to stereoscopic images and interrogated them using a mixed-reality system. The morphological features identified on the stereoscopic models were compared with findings at macroscopic examination of the actual heart specimens. T...
Source: Pediatric Radiology - July 1, 2020 Category: Radiology Source Type: research

Structural and perfusion magnetic resonance imaging of congenital lung malformations
ConclusionA dedicated lung MRI protocol including respiratory compensated sequences, dynamic angiography and perfusion is able to reliably delineate parenchymal and vascular components of congenital bronchopulmonary foregut malformations. Therefore, MRI may be considered for comprehensive postnatal evaluation of congenital thoracic malformations. (Source: Pediatric Radiology)
Source: Pediatric Radiology - July 1, 2020 Category: Radiology Source Type: research

Hermes
(Source: Pediatric Radiology)
Source: Pediatric Radiology - July 1, 2020 Category: Radiology Source Type: research

Connectome mapping with edge density imaging differentiates pediatric mild traumatic brain injury from typically developing controls: proof of concept
ConclusionIn this proof-of-concept study, we show that edge density imaging is a new form of connectome mapping that provides better diagnostic delineation between pediatric mild TBI and healthy controls than DTI or neurocognitive assessments of memory or attention. (Source: Pediatric Radiology)
Source: Pediatric Radiology - June 30, 2020 Category: Radiology Source Type: research

Look for the helpers
(Source: Pediatric Radiology)
Source: Pediatric Radiology - June 30, 2020 Category: Radiology Source Type: research

Normal hip joint fluid volumes in healthy children of different ages, based on MRI volumetric quantitative measurement
ConclusionA semiautomated pixel-based thresholding approach was feasible and reliable for measuring joint fluid in pediatric hip MRI. The average fluid volume of 2.1  mL can represent a visually substantial quantity of fluid per MRI slice, particularly in small children, and should not be misinterpreted as a joint effusion. (Source: Pediatric Radiology)
Source: Pediatric Radiology - June 29, 2020 Category: Radiology Source Type: research

Comparison of quantitative image quality of cardiac computed tomography between raw-data-based and model-based iterative reconstruction algorithms with an emphasis on image sharpness
AbstractBackgroundImage sharpness is commonly degraded on cardiac CT images reconstructed using iterative reconstruction algorithms.ObjectiveTo compare the image quality of cardiac CT between raw-data-based and model-based iterative reconstruction algorithms developed by the same CT vendor in children and young adults with congenital heart disease.Materials and methodsIn 29 patients with congenital heart disease, we reconstructed 39 cardiac CT datasets using raw-data-based and model-based iterative reconstruction algorithms. We performed quantitative analysis of image sharpness using distance25 –75% and angle25 &ndas...
Source: Pediatric Radiology - June 26, 2020 Category: Radiology Source Type: research

Assessing changes in microstructural integrity of white matter tracts in children with leukaemia following exposure to chemotherapy
ConclusionThe quantification of white matter tracts changes in children undergoing chemotherapy showed improving longitudinal values in DTI metrics (stable fractional anisotropy, decreasing mean and radial diffusivity), which are incompatible with deterioration of microstructural integrity in these children. (Source: Pediatric Radiology)
Source: Pediatric Radiology - June 26, 2020 Category: Radiology Source Type: research

Two-dimensional ultrasound shear wave elastography for identifying and staging liver fibrosis in pediatric patients with known or suspected liver disease: a clinical effectiveness study
ConclusionTwo-dimensional ultrasound SWE distinguishes patients with no/mild fibrosis from those with moderate/severe fibrosis with good sensitivity and specificity. Diagnostic performance is comparable to that published for magnetic resonance elastography and is likely adversely impacted by steatosis. (Source: Pediatric Radiology)
Source: Pediatric Radiology - June 25, 2020 Category: Radiology Source Type: research

Whole-body magnetic resonance imaging in children – how and why? A systematic review
AbstractWhole-body magnetic resonance imaging (MRI) is increasingly being used for a number of indications. Our aim was to review and describe indications and scan protocols for diagnostic value of whole-body MRI for multifocal disease in children and adolescents, we conducted a systematic search in Medline, Embase and Cochrane for all published papers until November 2018. Relevant subject headings and free text words were used for the following concepts: 1) whole-body, 2) magnetic resonance imaging and 3) child and/or adolescent. Included were papers in English with a relevant study design that reported on the use and/or ...
Source: Pediatric Radiology - June 25, 2020 Category: Radiology Source Type: research

Intrahepatic veno-venous collateralization and misrepresentative hepatic venous pressure gradients in children
ConclusionHV-HV collateralization is frequently observed in children undergoing wedged portal venography and leads to misrepresentative hepatic venous pressure gradients. All patients undergoing hepatic venous pressure gradient measurement should have wedged venography to identify HV-HV collaterals and to qualify measured pressures. Additional techniques to obtain representative pressures in the presence of HV-HV collaterals warrant further investigation. (Source: Pediatric Radiology)
Source: Pediatric Radiology - June 24, 2020 Category: Radiology Source Type: research

Pediatric Radiology Continuing Medical Education Activity
(Source: Pediatric Radiology)
Source: Pediatric Radiology - June 24, 2020 Category: Radiology Source Type: research

Minimally invasive treatment of retrocardiac tension pneumomediastinum in an extremely low birth weight infant
We report the successful definitive percutaneous management of retrocardiac tension pneumomediastinum with a minimally invasive bedside method using an intercostal para spinal approach under the guidance of ultrasound and plain radiography. (Source: Pediatric Radiology)
Source: Pediatric Radiology - June 20, 2020 Category: Radiology Source Type: research

European overview of current practice of fetal imaging by pediatric radiologists: a new task force is launched
AbstractA new task force dedicated to prenatal imaging was created in 2018 by the European Society of Pediatric Radiology. In order to establish a network of European prenatal imaging practice, we sent a questionnaire to radiologists practicing prenatal imaging in Europe. The questions were related to the type of institution, the local legislation for termination of pregnancy, the type of imaging modality and the following items regarding magnetic resonance imaging (MRI): magnetic field, gestational age at which it is performed, use of maternal sedation, number of examinations per year, proportion of cerebral versus body i...
Source: Pediatric Radiology - June 18, 2020 Category: Radiology Source Type: research

Emotional engagement in learning through humor and storytelling
(Source: Pediatric Radiology)
Source: Pediatric Radiology - June 18, 2020 Category: Radiology Source Type: research

Computed tomography and magnetic resonance imaging in pediatric salivary gland diseases: a guide to the differential diagnosis
AbstractSalivary gland pathologies in children are frequent, particularly viral infections, but rarely need cross-sectional imaging. However, when a mass involves the salivary spaces (primarily or as a secondary invasion from other neck spaces) it may pose problems in the differential diagnosis and in immediate management. Infrequently, systemic autoimmune diseases can also involve the salivary parenchyma in children and correctly interpreting the constellation of findings in the whole body is critical for the diagnosis. Distinguishing between cystic and solid masses is the first step for radiologists in order to narrow do...
Source: Pediatric Radiology - June 18, 2020 Category: Radiology Source Type: research

Coronavirus disease 2019 (COVID-19) in children: a systematic review of imaging findings
AbstractBackgroundCOVID-19 is a novel coronavirus infection that can cause a severe respiratory illness and has been declared a pandemic by the World Health Organization (WHO). Because children appear to be less severely affected than adults, their imaging appearances have not been extensively reported.ObjectiveTo systematically review available literature regarding imaging findings in paediatric cases of COVID-19.Materials and methodsWe searched four databases (Medline, Embase, Cochrane, Google Scholar) for articles describing imaging findings in children with COVID-19. We included all modalities, age
Source: Pediatric Radiology - June 18, 2020 Category: Radiology Source Type: research

Dual-source computed tomography of the lung with spectral shaping and advanced iterative reconstruction: potential for maximum radiation dose reduction
AbstractBackgroundRadiation dose at CT should be as low as possible without compromising diagnostic quality.ObjectiveTo assess the potential for maximum dose reduction of pediatric lung dual-source CT with spectral shaping and advanced iterative reconstruction (ADMIRE).Materials and methodsWe retrospectively analyzed dual-source CT acquisitions in a full-dose group (FD: 100  kV, 64 reference mAs) and in three groups with spectral shaping and differing reference mAs values (Sn: 100 kV, 96/64/32 reference mAs), each group consisting of 16 patients (age mean 11.5 years, standard deviation 4.8 years, median...
Source: Pediatric Radiology - June 17, 2020 Category: Radiology Source Type: research

Serial Doppler velocimetry of mesenteric and portal flow in very-low-birth-weight preterm neonates with and without patent ductus arteriosus
AbstractBackgroundVery-low-birth-weight (VLBW) preterm neonates are vulnerable to patent ductus arteriosus (PDA), which might be related to high-resistance flow in the superior mesenteric artery (SMA), with decreased diastolic flow in situations of marked intestinal hypoperfusion. No previous studies have evaluated the portal vein and superior mesenteric vein (SMV) parameters to assess the PDA hemodynamic repercussions.ObjectiveTo assess mesenteric and portal flow in VLBW preterm neonates with or without PDA using serial Doppler ultrasonography (US).Materials and methodsWe conducted a prospective longitudinal study on 61 V...
Source: Pediatric Radiology - June 16, 2020 Category: Radiology Source Type: research

Validation of threshold values for pancreas thickness and T1-weighted signal intensity ratio in the pediatric pancreas
ConclusionPreviously defined thresholds for pancreas thickness and pancreas:spleen T1-weighted signal intensity ratio appear too restrictive for a pediatric population. Further study is needed to define optimal quantitative metrics for findings of chronic pancreatitis in children. (Source: Pediatric Radiology)
Source: Pediatric Radiology - June 16, 2020 Category: Radiology Source Type: research

The desire to make a difference: Sir William Osler
(Source: Pediatric Radiology)
Source: Pediatric Radiology - June 11, 2020 Category: Radiology Source Type: research

Radiographic findings predictive of irreducibility and surgical resection in ileocolic intussusception
ConclusionRadiographs can offer prognostic information regarding the potential for therapeutic enema success, as well as potential surgical outcomes in patients failing enema reduction. Particularly, bowel obstruction significantly decreases the success of therapeutic enema and increases the need for bowel resection. (Source: Pediatric Radiology)
Source: Pediatric Radiology - June 9, 2020 Category: Radiology Source Type: research

Abdominal lymph node size in children at computed tomography
ConclusionThe results of this study provide normative data of abdominal lymph node size in children. The current adult guidelines for enlarged lymph nodes seem adequate for most children with the exception of young adolescents, in which larger lymph nodes were relatively common, particularly in the inguinal region. (Source: Pediatric Radiology)
Source: Pediatric Radiology - June 7, 2020 Category: Radiology Source Type: research

Congenital central pulmonary artery anomalies: Part 2
AbstractThere is a broad spectrum of congenital anomalies of the central pulmonary arteries including abnormalities of development, origin, course and caliber. These anomalies incorporate simple lesions such as isolated pulmonary valve stenosis to very complex anomalies with many associated abnormalities. Part 1 and Part 2 of this review describe the range of anatomical variations that are encountered as well as important aspects of anatomy, physiology and surgical correction. The authors summarize and illustrate both well-recognized and more complex anomalies to provide a broad and comprehensive understanding of these les...
Source: Pediatric Radiology - June 4, 2020 Category: Radiology Source Type: research

Preparedness for the COVID-19 pandemic in a tertiary pediatric radiology department
(Source: Pediatric Radiology)
Source: Pediatric Radiology - June 3, 2020 Category: Radiology Source Type: research

Imaging features of pathologically proven pediatric splenic masses
AbstractSplenic masses present a diagnostic challenge to radiologists and clinicians alike, with a relative paucity of data correlating radiologic findings to pathological diagnosis in the pediatric population. To illustrate splenic mass imaging findings and approximate lesion prevalence, we retrospectively reviewed all splenectomies and splenic biopsies for splenic masses at a single academic pediatric hospital over a 10-year period in patients 18  years and younger. A total of 31 splenic masses were analyzed. Lesion prevalence, pathology and imaging features associated with sampled splenic masses are described. The ...
Source: Pediatric Radiology - June 3, 2020 Category: Radiology Source Type: research

E-cigarette or vaping product use-associated lung injury in the pediatric population: imaging features at presentation and short-term follow-up
ConclusionPulmonary opacities with subpleural and peribronchovascular sparing was a commonly observed pattern of EVALI in the pediatric population at this institution. A CXR may not be sufficiently sensitive in diagnosing EVALI, and radiologists and clinicians should exercise caution when excluding EVALI based on the lack of a pulmonary opacity. Caution should also be exercised when excluding EVALI solely based on the lack of respiratory symptoms. Despite extensive pulmonary involvement at presentation, findings may resolve on short-term follow-up imaging. (Source: Pediatric Radiology)
Source: Pediatric Radiology - June 3, 2020 Category: Radiology Source Type: research

Pediatric applications of Dotatate: early diagnostic and therapeutic experience
This article provides a multicenter case series of Dotatate imaging and therapy in pediatric patients in order to highlight the spectrum of potential clinical applications. (Source: Pediatric Radiology)
Source: Pediatric Radiology - June 3, 2020 Category: Radiology Source Type: research

Transpubic variant of congenital prepubic sinus on magnetic resonance imaging
We report a case of congenital prepubic sinus with this unusual transpubic course in an 18-year-old man. The patient was initially taken to the operating room for excision of a presumed inclusion cyst. At the time of surgery, the collection was found to track proximally and was excised down to the level of the pubic symphysis. Subsequent magnetic resonance (MR) imaging established the diagnosis of congenital prepubic sinus. We describe the different anatomical courses of congenital prepubic sinus, hypotheses of its pathogenesis, and the use of MR imaging in both diagnosis and surgical planning. (Source: Pediatric Radiology)
Source: Pediatric Radiology - June 1, 2020 Category: Radiology Source Type: research

Five facets of fulfillment in pediatric radiology
(Source: Pediatric Radiology)
Source: Pediatric Radiology - June 1, 2020 Category: Radiology Source Type: research

Interpretation of pediatric chest radiographs by non-radiologist clinicians in Botswana
(Source: Pediatric Radiology)
Source: Pediatric Radiology - June 1, 2020 Category: Radiology Source Type: research

Chest computed tomography in children with COVID-19
(Source: Pediatric Radiology)
Source: Pediatric Radiology - June 1, 2020 Category: Radiology Source Type: research

The pediatric stomach — masses and mass-like pathology
AbstractDiagnostic imaging of pediatric gastric masses often provides a challenge for the practicing radiologist. Radiologists should be aware of this relatively unusual pathology, particularly in cross-sectional imaging findings. We will review pediatric gastric masses and mass-like lesions, focusing on neoplastic and inflammatory etiologies. (Source: Pediatric Radiology)
Source: Pediatric Radiology - May 30, 2020 Category: Radiology Source Type: research

The growing issue of burnout in radiology — a survey-based evaluation of driving factors and potential impacts in pediatric radiologists
AbstractBackgroundBurnout in medicine, and specifically radiology, has been receiving more attention. Little data-driven literature is available regarding risk factors/causes to ultimately help guide the development of potential solutions.ObjectiveTo survey pediatric radiologists, a cohort with a documented high prevalence of burnout, and to understand the impact of clinical demands on nonclinical tasks and the implications of burnout on mental health.Materials and methodsA survey of Society for Pediatric Radiology (SPR) North America attendings was performed regarding institutional factors contributing to burnout, includi...
Source: Pediatric Radiology - May 30, 2020 Category: Radiology Source Type: research

Congenital central pulmonary artery anomalies: Part 1
AbstractThere is a broad spectrum of congenital anomalies of the central pulmonary arteries including abnormalities of development, origin, course and caliber. These anomalies incorporate simple lesions such as isolated pulmonary valve stenosis to very complex anomalies with many associated abnormalities. Part 1 and Part 2 of this review describe the range of anatomical variations that are encountered as well as important aspects of anatomy, physiology and surgical correction. The authors summarize and illustrate well-recognized as well as more complex anomalies to provide a broad and comprehensive understanding of these l...
Source: Pediatric Radiology - May 30, 2020 Category: Radiology Source Type: research

Stresses and anxieties in the time of the COVID-19 pandemic — what we can learn
(Source: Pediatric Radiology)
Source: Pediatric Radiology - May 30, 2020 Category: Radiology Source Type: research

Life after plague
(Source: Pediatric Radiology)
Source: Pediatric Radiology - May 30, 2020 Category: Radiology Source Type: research

Imaging of complications following Fontan circulation in children — diagnosis and surveillance
AbstractThe Fontan operation is performed for various cardiac lesions with single-ventricle physiology. The survival rate of Fontan patients is increasing for adolescents and young adults, with an expected 30-year survival of>80%. Medical health care providers including specialists in organ systems and pediatric radiologists need to improve their knowledge about the Fontan circulation and the various organ complications to monitor care. In this review the author explains the basic anatomical and functional features of Fontan palliation and gives an overview of the multiple long-term organ complications that might presen...
Source: Pediatric Radiology - May 28, 2020 Category: Radiology Source Type: research