Comparison of conventional and simulated reduced-tube current MDCT for evaluation of suspected appendicitis in the pediatric population.

Objective: The purpose of this study was to compare CT with conventional and simulated reduced-tube current in the evaluation for acute appendicitis in children.

Materials And Methods: Validated noise-addition (tube current-reduction) software was used to create 50% and 75% tube current reductions in 60 CT examinations performed for suspected appendicitis, resulting in 180 image sets. Three blinded pediatric radiologists scored the randomized studies for the following factors: presence of the normal appendix or appendicitis (5-point scale; 1=definitely absent and 5=definitely present), presence of alternate diagnoses, and overall image quality (1=nondiagnostic and 5=excellent).

Lung nodule detection in pediatric chest CT: quantitative relationship between image quality and radiologist performance.

Purpose: To determine the quantitative relationship between image quality and radiologist performance in detecting small lung nodules in pediatric CT.

Methods: The study included clinical chest CT images of 30 pediatric patients (0-16 years) scanned at tube currents of 55-180 mA. Calibrated noise addition software was used to simulate cases at three nominal mA settings: 70, 35, and 17.

The Duke Abdominal Assessment Scale: initial experience.

Plain abdominal radiographs are the current standard imaging modality of choice in the evaluation of patients with clinically suspected necrotizing enterocolitis. The time interval between radiographic exams varies with the severity of disease and may range from every 6 h to every 24 h. Radiographs are often also obtained at any point of acute clinical deterioration.

American Board of Radiology certifying examination: oral versus computer-based format.

Objective: This pilot study of a computer-based examination for primary certification by the American Board of Radiology was designed to acquire comparative data on candidates that were measures of individual performance on the oral examination compared with the computer-based examination.

Materials And Methods: The pilot computer-based pediatric radiology examination was designed by experienced oral board examiners and the pediatric subspecialty trustees. Images were chosen from the examination repository of the American Board of Radiology.

Rescue therapy in adult and pediatric patients with pH1N1 influenza infection: a tertiary center intensive care unit experience from April to October 2009.

Objective: Severe respiratory failure is a well-recognized complication of pH1N1 influenza infection. Limited data regarding the efficacy of rescue therapies, including high-frequency oscillatory ventilation and extracorporeal membrane oxygenation, have been previously reported in the setting of pH1N1 influenza infection in the United States.

Design: Retrospective, single-center cohort study.

Synchronous occurrence of metastatic Wilms tumor and ganglioneuroma.

We describe a 4-year-old female patient with a persistent paraspinal mass following chemotherapy for Wilms tumor. A discordant response to chemotherapy prompted biopsy of the persistent mass, which revealed a ganglioneuroma. This report highlights the synchronous occurrence of different tumors in the same patient, and suggests that repeat biopsies should be considered when contiguous tumor masses do not respond as expected.

Hereditary spherocytosis and partial splenectomy in children: review of surgical technique and the role of imaging.

The risks associated with total splenectomy, including overwhelming postsplenectomy infection, have led to an interest in the use of partial splenectomy as an alternative surgical option for children with congenital hemolytic anemias and hypersplenism. Partial splenectomy, a procedure designed to remove enough spleen to improve anemia and avoid complications of splenic sequestration while preserving splenic function, has shown promise in children. Radiologic imaging is essential for the preoperative evaluation and postoperative care for children undergoing partial splenectomy and offers a broad range of critical clinical information essential for care of these complex children.

Reversible cardiac dysfunction associated with pandemic 2009 influenza A(H1N1).

Historical influenza A epidemics have carried elevated rates of cardiovascular disease, including transient cardiac dysfunction. Whether such an association holds for the novel influenza A strain, pandemic 2009 influenza A(H1N1) [A(H1N1)], remains unknown. We report an index case of transient cardiac dysfunction associated with A(H1N1) infection.

Prospective double-blinded study of abdominal-pelvic computed tomography guided by the region of tenderness: estimation of detection of acute pathology and radiation exposure reduction.

Study Objective: Computed tomography (CT) is increasingly used for emergency department (ED) patients with abdominal tenderness. CT-related radiation contributes to 2% of US cancers. We hypothesized that in the ED patient with nontraumatic abdominal tenderness, the tender region accurately delineates acute pathology.

Radiographic predictors of disease severity in neonates and infants with necrotizing enterocolitis.

Objective: The objective of our study was to validate a radiographic scale, the Duke abdominal assessment scale (DAAS), as a tool for predicting the severity of disease in neonates and infants with suspected necrotizing enterocolitis (NEC).

Materials And Methods: Study group patients (n = 43) underwent at least two two-view abdominal radiographic series within 48 hours of surgical intervention for suspected NEC complications. Control group patients (n = 86) were patients with suspected NEC who did not undergo surgery for suspected NEC complications.

Pediatric MDCT: towards assessing the diagnostic influence of dose reduction on the detection of small lung nodules.

Rationale And Objectives: The purpose of this study was to evaluate the effect of reduced tube current (dose) on lung nodule detection in pediatric multidetector array computed tomography (MDCT).

Materials And Methods: The study included normal clinical chest MDCT images of 13 patients (aged 1-7 years) scanned at tube currents of 70 to 180 mA. Calibrated noise addition software was used to simulate cases as they would have been acquired at 70 mA (the lowest original tube current), 35 mA (50% reduction), and 17.

Pediatric hematopoietic stem cell transplantation and the role of imaging.

The use of hematopoietic stem cell transplantation (HSCT) in the treatment of children afflicted with many potentially fatal malignant and nonmalignant diseases is well recognized. Although outcomes continue to improve and the utility of HSCT is increasing, HSCT remains a complicated process necessitating support from many medical disciplines, including radiology. Importantly, children who undergo HSCT are at risk for the development of specific complications that are linked to the timeline of transplantation, as well as to the relationship between the underlying diagnoses, severe immune deficiency, cytoreductive regimen, and graft-versus-host reactions.

Radiologists' agreement when using a 10-point scale to report abdominal radiographic findings of necrotizing enterocolitis in neonates and infants.

Objective: The purpose of this study was to evaluate radiologists' agreement when using a 10-point scale of abnormal findings designed to standardize reporting of abdominal radiographs in neonates or infants with suspected necrotizing enterocolitis.

Materials And Methods: A 10-point scale of radiographic findings was devised at our institution and was in use for approximately 18 months before the initiation of this study. After institutional review board approval, 88 abdominal radiographs (anteroposterior and cross-table lateral) were randomly selected for review, allowing for an equal distribution of examinations throughout the scale according to the original examination report.

Pediatric cardiac-gated CT angiography: assessment of radiation dose.

Objective: The purpose of our study was to determine a dose range for cardiac-gated CT angiography (CTA) in children.

Materials And Methods: ECG-gated cardiac CTA simulating scanning of the heart was performed on an anthropomorphic phantom of a 5-year-old child on a 16-MDCT scanner using variable parameters (small field of view; 16 x 0.625 mm configuration; 0.

Computer-simulated radiation dose reduction for abdominal multidetector CT of pediatric patients.

Objective: Limiting CT radiation dose is especially critical when imaging children. The purpose of our study was to modify and test an accurate and safe tool for evaluating systematic dose reduction for abdominal multidetector CT (MDCT) in pediatric patients.

Materials And Methods: After validating the computer-simulation technique with a water phantom, we subjected the original digital scanning data for 26 contrast-enhanced abdominal MDCT scans (120 mA) obtained in infants and children (age range, 1 month-9 years; mean age, 3.