Imaging diagnosis of epipericardial fat necrosis in children
We report the imaging findings of epipericardial fat necrosis in a 15-year-old boy and additional images of a case in an 8-year-old boy. Pediatric radiologists should be cognizant of this condition to ensure appropriate diagnosis and avoid unnecessary invasive procedures. (Source: Pediatric Radiology)
Source: Pediatric Radiology - September 16, 2019 Category: Radiology Source Type: research

Growth recovery lines: a specific indicator of child abuse and neglect?
AbstractBackgroundGrowth recovery lines are radiodense lines in long bones reported to be indicators of stress.ObjectiveThe purpose of this study was to understand the distribution, quantity and associations of growth recovery lines in children ages 0 –24 months with high and low risk for child maltreatment.Materials and methodsWe conducted a retrospective cohort study of children ages 0 –24 months who had skeletal surveys and an assessment for maltreatment. Growth recovery lines, fractures and osteopenia were assessed independently by two pediatric radiologists blinded to the abuse likelihood.Results...
Source: Pediatric Radiology - September 14, 2019 Category: Radiology Source Type: research

Diagnostic accuracy of 3-T lung magnetic resonance imaging in human immunodeficiency virus-positive children
AbstractBackgroundMore than 70% of human immunodeficiency virus (HIV)-positive children sustain respiratory diseases in their lifetime. Imaging plays an important role in establishing early and correct diagnosis.ObjectiveTo evaluate the diagnostic accuracy of 3-Tesla (T) thorax MRI in HIV-positive children, using chest CT as the gold standard.Materials and methodsWe included 25 children with confirmed HIV-positive status and pulmonary complaints who were referred for chest CT. All children had 3-T thorax MRI using T2-W turbo spin-echo sequence, steady-state free precession gradient echo sequence, T2-W turbo spin-echo Multi...
Source: Pediatric Radiology - September 13, 2019 Category: Radiology Source Type: research

Atlanto-occipital ligament calcification: a novel imaging finding in pediatric rotational vertebral artery occlusion
We describe a 2-year-old girl with bow hunter syndrome complicated by vertebral artery dissection and multiple ischemic infarcts. Pediatric bow hunter syndrome is a rare and likely under-recognized disorder. Interestingly, our patient had atlanto-occipital ligament calcification on CT scan, an imaging finding that has not been reported in association with bow hunter syndrome and one that might help increase recognition of this dynamic disorder of the posterior circulation. (Source: Pediatric Radiology)
Source: Pediatric Radiology - September 11, 2019 Category: Radiology Source Type: research

The role of sonography for depiction of a whirlpool sign unrelated to midgut malrotation in neonates
ConclusionThis study illustrates neonates in whom a whirlpool sign (unrelated to midgut volvulus) was correctly recognized on sonography before surgery. Sonography proved more useful than an upper gastrointestinal series or contrast enema in depicting the exact cause of the obstruction. Pediatric radiologists must make the effort to search throughout the entire abdomen and pelvis for a small whirlpool sign on sonography, even in the absence of midgut malrotation, in neonates with congenital intestinal obstruction. Its recognition preoperatively will facilitate a rapid diagnosis and will obviate the necessity for contrast e...
Source: Pediatric Radiology - September 10, 2019 Category: Radiology Source Type: research

Impact on child and parent anxiety level of a teddy bear-scale mock magnetic resonance scanner
ConclusionA mock scanner was an efficient tool to improve efficiency of the explanation and to decrease anxiety in children and motion artifacts in pediatric MRI. (Source: Pediatric Radiology)
Source: Pediatric Radiology - September 9, 2019 Category: Radiology Source Type: research

Impact of a fast free-breathing 3-T abdominal MRI protocol on improving scan time and image quality for pediatric patients with tuberous sclerosis complex
AbstractBackgroundMagnetic resonance imaging (MRI) of the abdomen can be especially challenging in pediatric patients because of image quality degradation from respiratory motion. Abdominal MR protocols tailored for free-breathing children can potentially improve diagnostic image quality and reduce scan time.ObjectiveTo evaluate the performance of a free-breathing 3-T MRI protocol for renal evaluation in pediatric patients with tuberous sclerosis complex (TSC).Materials and methodsA single institution, Institutional Review Board-approved, retrospective database query identified pediatric TSC patients who underwent a free-b...
Source: Pediatric Radiology - September 4, 2019 Category: Radiology Source Type: research

Prenatal imaging of anorectal malformations — 10-year experience at a tertiary center in Switzerland
ConclusionThe most important signs suggesting anorectal malformation are an absent target sign and anomalous distal bowel wall and rectal fluid. Complementary prenatal MRI improves the diagnosis of anorectal malformation. (Source: Pediatric Radiology)
Source: Pediatric Radiology - September 3, 2019 Category: Radiology Source Type: research

Lung ultrasound for detecting pneumothorax in injured children: preliminary experience at a community-based Level II pediatric trauma center
ConclusionPneumothorax is less common in the pediatric than the adult trauma population, and when encountered in children pneumothorax is often occult and might be associated with lung contusions. Existing evidence supports the usefulness of chest US in detecting pneumothorax in adults and suggests that it can be translated to injured children. However, our findings suggest that the sensitivity of lung US as a single-point anterior exam extension of the FAST exam might not be as reliable in the pediatric trauma population as in adults. Other methodologies using lung US might improve sensitivity. (Source: Pediatric Radiology)
Source: Pediatric Radiology - August 31, 2019 Category: Radiology Source Type: research

A new imaging entity consistent with partial ectopic posterior pituitary gland: report of six cases
ConclusionWe describe an unreported imaging entity suggesting partial ectopic posterior pituitary gland in six children. Anterior pituitary hormone deficiencies might be detected in those children and long-term follow-up could provide additional information on the development of other pituitary hormone deficiencies. (Source: Pediatric Radiology)
Source: Pediatric Radiology - August 30, 2019 Category: Radiology Source Type: research

2-D magnetic resonance spectroscopic imaging of the pediatric brain using compressed sensing
ConclusionCompressed-sensing MR spectroscopic imaging has the potential to reduce MR spectroscopic imaging scan times for pediatric patients, with negligible information loss. (Source: Pediatric Radiology)
Source: Pediatric Radiology - August 28, 2019 Category: Radiology Source Type: research

Hermes
(Source: Pediatric Radiology)
Source: Pediatric Radiology - August 27, 2019 Category: Radiology Source Type: research

The current status of non-radiologist-performed abdominal ultrasonography in paediatrics – a scoping literature review protocol
We present the background and study design of a scoping review for non-radiologist-performed abdominal point-of-care paediatric US using a formal scoping framework. The information shall be derived from published studies. We will submit the review report to a peer-reviewed scientific journal and explore other scientific venues for presenting the work. Based on the completed review, the officers of the European Society of Paediatric Radiology will issue a position statement on non-radiologist-performed point-of-care paediatric US. (Source: Pediatric Radiology)
Source: Pediatric Radiology - August 27, 2019 Category: Radiology Source Type: research

Pediatric Radiology continuing medical education activity
(Source: Pediatric Radiology)
Source: Pediatric Radiology - August 27, 2019 Category: Radiology Source Type: research

Osteomyelitis of the ribs in children: a rare and potentially challenging diagnosis
ConclusionWhile rib osteomyelitis is rare, imaging findings of lytic changes at the costochondral junction combined with a history of fever, elevated inflammatory markers or localized soft-tissue swelling in the chest should raise suspicion for this disease. (Source: Pediatric Radiology)
Source: Pediatric Radiology - August 24, 2019 Category: Radiology Source Type: research

Dual-source computed tomography coronary artery imaging in children
AbstractComputed tomography (CT) has a well-established diagnostic role in the assessment of coronary arteries in adults. However, its application in a pediatric setting is still limited and often impaired by several technical issues, such as high heart rates, poor patient cooperation, and radiation dose exposure. Nonetheless, CT is becoming crucial in the noninvasive approach of children affected by coronary abnormalities and congenital heart disease. In some circumstances, CT might be preferred to other noninvasive techniques such as echocardiography and MRI for its lack of acoustic window influence, shorter acquisition ...
Source: Pediatric Radiology - August 22, 2019 Category: Radiology Source Type: research

Ultrasonography with the colonic segment-approach for colonic polyps in children
AbstractBackgroundUltrasonography (US) has been widely applied and has validated efficacy in the diagnosis of colonic polyps in children. However, little attention has been paid to improving the detection rate of polyps, optimizing the ultrasonic examination process and reducing misdiagnosis.ObjectiveTo investigate the diagnostic performance of the colonic segment-approach by US in the diagnosis of colonic polyps in pediatric patients.Materials and methodsOne hundred fifty-nine patients who were going to have a colonoscopy from September 2014 to August 2016 were enrolled in this study. All patients received US before colon...
Source: Pediatric Radiology - August 22, 2019 Category: Radiology Source Type: research

Ultrasound detection of crystal gel ball ingestion in children
(Source: Pediatric Radiology)
Source: Pediatric Radiology - August 22, 2019 Category: Radiology Source Type: research

Hypothalamic hamartomas and inner ear diverticula with X-linked stapes gusher syndrome - new associations?
We report a potential association between these two rare anomalies that, to our knowledge, has not been reported. Two brothers presented with sensorineural hearing loss and almost identical inner ear and hypothalamic abnormalities, consistent with a diagnosis of X-linked stapes gusher syndrome and hypothalamic hamartoma. Genetic testing revealed identical mutations in thePOU3F4 gene associated with X-linked stapes gusher syndrome. Furthermore, multiple vestibular diverticula were seen in both brothers, which have also not been reported with X-linked stapes gusher syndrome. This case suggests thatPOU3F4 mediated X-linked st...
Source: Pediatric Radiology - August 22, 2019 Category: Radiology Source Type: research

Normal sonographic renal length measurements in an Australian pediatric population
ConclusionWe calculated new reference ranges for pediatric renal length using a larger cohort than previously published, from a population with diverse ethnicity. (Source: Pediatric Radiology)
Source: Pediatric Radiology - August 19, 2019 Category: Radiology Source Type: research

Association between ventricular shunt catheter calcifications and the development of shunt fracture
AbstractBackgroundCalcifications along ventricular catheters have been associated with shunt fractures although it is unknown whether their development predicts whether and when the shunts will fracture.ObjectiveTo determine whether extracranial calcifications found on a radiographic shunt series predicts whether a patient will experience a shunt catheter fracture or complication.Materials and methodsA retrospective review was performed of pediatric patients with a ventricular shunt placed before 18  years of age and radiographic shunt series. Two thousand, six hundred and thirty shunt series in 523 patients (301 male...
Source: Pediatric Radiology - August 16, 2019 Category: Radiology Source Type: research

Shear wave elastography correlates with liver fibrosis scores in pediatric patients with liver disease
AbstractBackgroundWhile liver biopsy remains the gold standard, given the procedure risks and sampling errors, there is a need for reliable noninvasive biomarkers of hepatic fibrosis.ObjectiveDetermine the accuracy of two-dimensional shear wave elastography (2-D SWE) in predicting the histological severity of liver fibrosis in pediatric patients with known or suspected liver disease.Materials and methodsSubjects 0 –18 years old with known or suspected liver disease and liver biopsy within 30 days (n=70) were included. Comparisons by 2-D SWE were made to a control group (n=79). Two-dimensional SWE was perfor...
Source: Pediatric Radiology - August 15, 2019 Category: Radiology Source Type: research

A multifactorial severity score for left congenital diaphragmatic hernia in a high-risk population using fetal magnetic resonance imaging
AbstractBackgroundAdverse outcomes for infants born with left congenital diaphragmatic hernia (CDH) have been correlated with fetal imaging findings.ObjectiveWe sought to corroborate these correlations in a high-risk cohort and describe a predictive mortality algorithm combining multiple imaging biomarkers for use in prenatal counseling.Materials and methodsWe reviewed fetal MRI examinations at our institution from 2004 to 2016 demonstrating left-side CDH. MRI findings, hospital course and outcomes were recorded and analyzed using bivariate and multivariable analysis. We generated a receiver operating curve (ROC) to determ...
Source: Pediatric Radiology - August 14, 2019 Category: Radiology Source Type: research

The heart of pediatric radiology
(Source: Pediatric Radiology)
Source: Pediatric Radiology - August 14, 2019 Category: Radiology Source Type: research

Olfactory bulb and olfactory tract abnormalities in acrocallosal syndrome and Greig cephalopolysyndactyly syndrome
We describe association of olfactory bulb and olfactory tract abnormalities in a child with acrocallosal syndrome caused by kinesin family membrane 7 (KIF7) mutation in sonic hedgehog pathway. The child also had fontanellar bone in the anterior fontanelle, short sagittal suture, sagittal synostosis, hippocampal malrotation and Joubert malformation. Fontanellar bone has been described inGLI3 mutation and mutant mice models but has not been reported inKIF7 mutation. We briefly review the role of sonic hedgehog pathway and its componentsKIF7 andGLI3 in forebrain and olfactory system development and also describe olfactory sys...
Source: Pediatric Radiology - August 9, 2019 Category: Radiology Source Type: research

Effects of an MRI Try Without program on patient access
ConclusionUtilization of an MRI Try Without sedation program, with child life specialist interventions, decreased the wait time for obtaining an MRI while still providing diagnostic-quality images. (Source: Pediatric Radiology)
Source: Pediatric Radiology - August 8, 2019 Category: Radiology Source Type: research

Prenatal evaluation of the Sakoda complex
AbstractSakoda complex is a rare but distinct combination of birth defects consisting of a basal cephalocele, agenesis of the corpus callosum, and midline cleft lip/palate. It has been reported in association with ophthalmologic abnormalities, cognitive deficits and severe epilepsy. Here we describe both prenatal and postnatal MRI findings of a classic case of Sakoda complex in a child with characteristic findings on fetal MRI; prenatal findings have not been described in the literature. Diagnosis of this entity has important implications for prenatal counseling and perinatal management, as is demonstrated in this case. (S...
Source: Pediatric Radiology - August 5, 2019 Category: Radiology Source Type: research

Classic metaphyseal lesion of distal tibia following footling breech delivery
We report a distal tibial metaphyseal fracture following a difficult breech delivery. Classic metaphyseal fractures are considered highly specific injuries associated with non-accidental trauma. This case depicts a classic metaphyseal lesion sustained during footling breech extraction in an urgent delivery. The traction and torque placed on the distal extremities during this difficult delivery suggest a potential mechanism for this injury. (Source: Pediatric Radiology)
Source: Pediatric Radiology - August 5, 2019 Category: Radiology Source Type: research

Clinically occult abusive head trauma: which age group should we screen?
(Source: Pediatric Radiology)
Source: Pediatric Radiology - July 27, 2019 Category: Radiology Source Type: research

Bone age determination in eutrophic, overweight and obese Brazilian children and adolescents: a comparison between computerized BoneXpert and Greulich-Pyle methods
AbstractBackgroundBone age determination is usually employed to evaluate growth disorders and their treatment. The Greulich-Pyle method is the simplest and most frequently used type of evaluation, but it presents huge interobserver variability. The BoneXpert is a computer-automated method developed to avoid significant bone age variability among distinct observers.ObjectiveTo compare the BoneXpert and Greulich-Pyle methods of bone age determination in eutrophic children and adolescents, as well as in overweight and obese pediatric patients.Materials and methodsThe sample comprised 515 participants, 253 boys (159 eutrophic,...
Source: Pediatric Radiology - July 26, 2019 Category: Radiology Source Type: research

Clinico-radiologic features of pleuroparenchymal fibroelastosis in children
ConclusionClinical and radiologic findings of pediatric PPFE are similar to those in adults, although a majority of the former have a history of treated cancer. Clinical presentation of restrictive lung disease, dyspnea, cough or spontaneous pneumothorax years after treatment for childhood cancer combined with platythorax, upper lobe pleural and septal thickening and traction bronchiectasis on chest CT establishes a presumptive diagnosis of PPFE. (Source: Pediatric Radiology)
Source: Pediatric Radiology - July 26, 2019 Category: Radiology Source Type: research

Hermes
(Source: Pediatric Radiology)
Source: Pediatric Radiology - July 26, 2019 Category: Radiology Source Type: research

Intravenous gadolinium-based hepatocyte-specific contrast agents (HSCAs) for contrast-enhanced liver magnetic resonance imaging in pediatric patients: what the radiologist should know
AbstractHepatocyte-specific contrast agents (HSCAs) are a group of intravenous gadolinium-based MRI contrast agents that can be used to characterize hepatobiliary pathology. The mechanism by which these agents are taken up by hepatocytes and partially excreted into the biliary tree improves characterization of hepatic lesions and biliary abnormalities relative to conventional extracellular gadolinium-based contrast agents (GBCAs). This manuscript presents an overview of HSCA use in pediatric patients with the intent to provide radiologists a guide for clinical use. We review available HSCAs and discuss dosing and age speci...
Source: Pediatric Radiology - July 26, 2019 Category: Radiology Source Type: research

Analysis of ovarian volume of Korean children and adolescents at magnetic resonance imaging
ConclusionOur findings provide age-specific references for ovarian volume. (Source: Pediatric Radiology)
Source: Pediatric Radiology - July 25, 2019 Category: Radiology Source Type: research

Maer B. (Mike) Ozonoff, MD (1930 –2019)
(Source: Pediatric Radiology)
Source: Pediatric Radiology - July 25, 2019 Category: Radiology Source Type: research

Diagnostic performance of standardized ultrasound protocol for detecting perforation in pediatric appendicitis
ConclusionThe diagnostic performance of ultrasound using a standardized US technique was similar to that reported in prior studies for detecting perforated appendicitis. Despite low sensitivity, individual ultrasound findings and overall diagnostic impression of “evidence of appendix perforation” remain highly specific. (Source: Pediatric Radiology)
Source: Pediatric Radiology - July 24, 2019 Category: Radiology Source Type: research

Pancreatic pseudocyst drainage in children by image-guided cystogastrostomy and stent insertion
ConclusionPancreatic pseudocyst drainage can be successfully performed in children by image-guided placement of a cystogastrostomy stent. In this cohort of six children there were no complications. (Source: Pediatric Radiology)
Source: Pediatric Radiology - July 24, 2019 Category: Radiology Source Type: research

Whole-body magnetic resonance imaging in paediatric Hodgkin lymphoma — evaluation of quantitative magnetic resonance metrics for nodal staging
AbstractBackgroundWhole-body MRI is used for staging paediatric Hodgkin lymphoma, commonly using size thresholds, which fail to detect disease in normal-size lymph nodes.ObjectiveTo investigate quantitative whole-body MRI metrics for nodal characterisation.Materials and methodsThirty-seven children with Hodgkin lymphoma underwent 1.5-tesla (T) whole-body MRI using short tau inversion recovery (STIR) half-Fourier-acquisition single-shot turbo-spin-echo and diffusion-weighted imaging (DWI).18Flourine-2-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET)/CT was acquired as the reference standard. Two independent re...
Source: Pediatric Radiology - July 22, 2019 Category: Radiology Source Type: research

Procedural pain reduction strategies in paediatric nuclear medicine
ConclusionA combination of two pharmacological/adjuvant interventions may be more effective in reducing procedural pain compared with a single intervention. A comprehensive pain management program should consider all available interventions – pharmacological, adjuvant, physical and psychological. Further randomized clinical trials are needed to evaluate if a combination of two or more methods of pharmacological and adjuvant interventions are more effective to reduce procedural pain compared with only one method. (Source: Pediatric Radiology)
Source: Pediatric Radiology - July 17, 2019 Category: Radiology Source Type: research

Review of learning opportunity rates: correlation with radiologist assignment, patient type and exam priority
AbstractBackgroundCommon cause analysis of learning opportunities identified in a peer collaborative improvement process can gauge the potential risk to patients and opportunities to improve.ObjectiveTo study rates of learning opportunities based on radiologist assignment, patient type and exam priority at an academic children ’s hospital with 24/7 in-house attending coverage.Materials and methodsActively submitted peer collaborative improvement learning opportunities from July 2, 2016, to July 31, 2018, were identified. Learning opportunity rates (number of learning opportunities divided by number of exams in each c...
Source: Pediatric Radiology - July 17, 2019 Category: Radiology Source Type: research

A novel approach using volumetric dynamic airway computed tomography to determine positive end-expiratory pressure (PEEP) settings to maintain airway patency in ventilated infants with bronchopulmonary dysplasia
ConclusionDynamic airway CT shows promise to assist the clinician in determining PEEP settings to maintain airway patency in infants with BPD requiring long-term ventilator support. Further evaluation of the impact of this maneuver on gas exchange, cardiac output and other physiological measures is needed. (Source: Pediatric Radiology)
Source: Pediatric Radiology - July 16, 2019 Category: Radiology Source Type: research

Diagnostic yield and safety of ultrasound-guided bowel mass biopsies in children
ConclusionUS-guided bowel mass biopsy can be performed safely in children, with a high diagnostic yield and low complication rate. (Source: Pediatric Radiology)
Source: Pediatric Radiology - July 13, 2019 Category: Radiology Source Type: research

Evaluation of implanted venous port-a-caths in children with medical complexity and neurologic impairment
AbstractBackgroundChildren with medical complexity and associated neurologic impairment frequently face difficulties with venous access. Intermittently they require urgent intravenous administration of fluids and medication.ObjectiveTo analyze the use of implanted port-a-caths in children with medical complexity who have neurologic impairment and difficult venous access.Materials and methodsWe performed a single-center observational study of port-a-caths placed by interventional radiologists in children with medical complexity with neurologic impairment. We analyzed peripheral intravenous access attempts, peripheral intrav...
Source: Pediatric Radiology - July 13, 2019 Category: Radiology Source Type: research

Diagnostic performance of ultrasound without any colon preparation for detecting colorectal polyps in pediatric patients
ConclusionThe accuracy for detecting colorectal polyps by ultrasound was 89% (95% CI, 80 –95%) in our cohort. Polyps found in the rectum and relatively smaller polyps accounted for several false-negative cases. (Source: Pediatric Radiology)
Source: Pediatric Radiology - July 13, 2019 Category: Radiology Source Type: research

Low b-value (50 –100) diffusion-weighted images detect significantly more hyperintense liver lesions in children than T2-weighted images
ConclusionLow b-value DWI images are more sensitive than T2-W sequences in detecting hyperintense focal liver lesions in children. (Source: Pediatric Radiology)
Source: Pediatric Radiology - July 10, 2019 Category: Radiology Source Type: research

Differential pattern of Doppler signals at lower-extremity entheses of healthy children
AbstractBackgroundUltrasonography might be an important imaging method for assessing the pediatric enthesis. To diagnose pathology, knowledge of physiological findings is essential but limited.ObjectiveTo provide a detailed ultrasonographic assessment of four lower-extremity entheses in healthy adolescents as a reference for the correct interpretation of findings in children with rheumatic diseases.Materials and methodsThe quadriceps tendon, proximal and distal patella tendon, and Achilles enthesis were examined in B-mode, Power and color Doppler in 41 boys and girls ages 11 –14 years in neutral position and 30&...
Source: Pediatric Radiology - July 9, 2019 Category: Radiology Source Type: research

Non-visualization of the ovaries on pediatric transabdominal ultrasound with a non-distended bladder: Can adnexal torsion be excluded?
ConclusionNon-visualization of the ovaries with a non-distended bladder on transabdominal US study can help exclude clinically suspected adnexal torsion, alleviating the need for bladder filling and prolonging the wait time in the emergency department. Inclusion of non-visualization of the ovaries as one of the features in a predictive score for adnexal torsion should be considered. (Source: Pediatric Radiology)
Source: Pediatric Radiology - July 9, 2019 Category: Radiology Source Type: research

Endovascular treatment of surgical mesoportal and portosystemic shunt dysfunction in pediatric patients
ConclusionDysfunctional portosystemic surgical shunts are effectively managed by endovascular methods. While many shunts require reintervention, combined primary patency and assisted primary patency rates are excellent. (Source: Pediatric Radiology)
Source: Pediatric Radiology - July 4, 2019 Category: Radiology Source Type: research

Relationship of renal apparent diffusion coefficient and functional MR urography in children with pelvicalyceal dilation
ConclusionRenal ADC does not correlate with morphological and functional results of fMRU changes in children with pelvicalyceal dilation due to suspected or known ureteropelvic junction obstruction. (Source: Pediatric Radiology)
Source: Pediatric Radiology - June 28, 2019 Category: Radiology Source Type: research

Gadolinium retention and clearance after administration of macrocyclic magnetic resonance contrast agents to rats
(Source: Pediatric Radiology)
Source: Pediatric Radiology - June 28, 2019 Category: Radiology Source Type: research