Subpleural pulmonary cysts in children: Associations beyond Trisomy 21.

Background: Small air-filled peripheral subpleural cysts are a well-described feature of pulmonary anatomy at computerized tomographic (CT) scan in children with Trisomy 21, yet only anecdotally described in association with other pathologies. The significance of these cysts is unknown.

Objective: To investigate and explore the pathogenesis of these subpleural cysts in children.

Preoperative delineation of pulmonary fissural anatomy at multi-detector computed tomography in children with congenital pulmonary malformations and impact on surgical complications and postoperative course.

Background: Delineation of the anatomy and integrity of the pulmonary fissures at CT is important because anomalous or incomplete fissures might increase the risk of surgery and of postoperative complications.

Objective: To preoperatively evaluate the integrity of the pleural fissures in children with congenital lung malformations and determine whether anomalous fissural anatomy is a risk factor for a more complicated surgery and postoperative course.

Materials And Methods: We reviewed preoperative multi-detector CT scans of consecutive children who underwent open or thoracoscopic resection of a congenital pulmonary malformation from 2008 to 2018, to determine the integrity of the fissural anatomy, and compared these findings with the surgical report.

A homozygous mutation in the stem II domain of causes typical Roifman syndrome.

Roifman syndrome (OMIM# 616651) is a complex syndrome encompassing skeletal dysplasia, immunodeficiency, retinal dystrophy and developmental delay, and is caused by compound heterozygous mutations involving the Stem II region and one of the other domains of the gene. This small nuclear RNA gene is essential for minor intron splicing. The Canadian Centre for Primary Immunodeficiency Registry and Repository were used to derive patient information as well as tissues.

Magnetic resonance imaging of the mediastinum, chest wall and pleura in children.

The acceptance of applications for the use of chest MRI in children has been somewhat slow and selective. The use of MRI to image chest wall lesions is likely the most common and widely used indication, aside from the widespread and somewhat sophisticated use of MRI in imaging the cardiovascular structures of the chest. In this respect, fairly standard variations of T1-W, T2-W and contrast-enhanced imaging can be used, similar to the sequences used for musculoskeletal lesions elsewhere in the body.

Pulmonary arterial hypertension in children: diagnosis using ratio of main pulmonary artery to ascending aorta diameter as determined by multi-detector computed tomography.

Background: The ratio of the transverse diameter of the main pulmonary artery (MPA) to ascending aorta as determined at multi-detector CT is a tool that can be used to assess the pulmonary arterial size in cases of pulmonary arterial hypertension in children.

Objective: To establish a ratio of MPA to ascending aorta diameter using multi-detector CT imaging suggestive of pulmonary arterial hypertension in children. We hypothesize that a defined ratio of MPA to ascending aorta is identifiable on multi-detector CT and that higher ratios can be used to reliably diagnose the presence of pulmonary arterial hypertension in children.

Utility of MDCT MIP Postprocessing Reconstruction Images in Children With Hereditary Hemorrhagic Telangiectasia.

Objective: The aim of the study was to evaluate whether maximum intensity projection (MIP) images improve the detection and the delineation of the anatomic makeup of pulmonary nodules and/or arteriovenous malformations (pAVMs) in children with hereditary hemorrhagic telangiectasia (HHT).

Materials And Methods: Two radiologists (D.M.

MR imaging of the chest in children.

The application of magnetic resonance imaging (MRI) to diseases of the pediatric chest has been complicated, selective and cautious. More specifically, MRI of the pediatric lung has been a highly anticipated technique that has inherent great potential for improved imaging of the chest without the use of ionizing radiation. Practical issues impede the transition from multidetector computed tomography (MDCT) to MRI in some chest diseases in children, while other disease states are intrinsically easier to image using MRI.

Pulmonary embolism in children.

Pulmonary embolism (PE) has long been described in children. Nevertheless, most of the algorithms applied to patients within this age range, from diagnosis to therapy, have been adapted from adult protocols. This article reviews the progresses that occurred to PE in children placing them in historical perspective with the key events relevant to PE in adults.

Primary sclerosing cholangitis in children: utility of magnetic resonance cholangiopancreatography.

Background: Even when histologic findings are highly suggestive of primary sclerosing cholangitis (PSC), cholangiographic correlation is required for the diagnosis. The present gold standard, endoscopic retrograde cholangiopancreatography (ERCP), is invasive and associated with complications.

Objective: To evaluate the usefulness of magnetic resonance cholangiopancreatography (MRCP) in diagnosing PSC in children.

Tracheoesophageal fistula without esophageal atresia: are pull-back tube esophagograms needed for diagnosis?

Background: A pull-back tube esophagogram (PBTE) is widely accepted in the literature as the radiological investigation of choice for the diagnosis of tracheoesophageal fistula without esophageal atresia. However, PBTE is rarely performed in our institution, as we have been successful in confirming the presence of such fistulae with a contrast material swallow (CS). We hypothesized that PBTE is not the radiological investigation of choice for the diagnosis of the fistula in this condition.

The role of conservative management in congenital tracheal stenosis: an evidence-based long-term follow-up study.

Background/purpose: Surgery has been the management of choice for severe congenital tracheal stenosis (CTS). The role of conservative management of CTS however is not clear. The aim of this study is to characterize the natural history of CTS, review the radiologic evidence of tracheal growth, and evaluate the clinical outcome and selection criteria of conservative management of CTS.

Ileocolic intussusception mimicking the imaging appearance of midgut volvulus as a result of extrinsic duodenal obstruction.

Duodenal obstruction caused by ileocolic intussusception in the absence of intestinal malrotation is extremely rare. We present and discuss the imaging findings in an infant with an intussusception secondary to a duplication cyst in whom sonography also showed inversion of the orientation of the mesenteric vessels and a distended stomach. A contrast medium study revealed a proximal duodenal obstruction with a beak appearance suggestive of midgut volvulus.

Necrotizing enterocolitis: assessment of bowel viability with color doppler US.

Purpose: To determine whether absence of bowel wall perfusion at color Doppler ultrasonography (US) is indicative of bowel necrosis in neonates with necrotizing enterocolitis (NEC).

Materials And Methods: This study was approved by the research ethics board, and informed consent was obtained. Sixty-two neonates enrolled in the prospective study underwent US of the bowel wall.

Imatinib mesylate: an attractive alternative in young children with large, surgically challenging dermatofibrosarcoma protuberans.

To document the clinical activity of imatinib mesyalte in a child with a dermatofibrosarcoma protuberans (DFSP). An 18-month-old girl presented with a large extremity DFSP. As surgical resection would have caused unacceptable functional defects, imatinib mesylate was administered to induce tumor reduction and or stabilization.

Hepatic and colonic perforation by an abandoned ventriculoperitoneal shunt.

We report a case of an abandoned distal limb of a ventriculoperitoneal shunt that resulted in hepatic as well as colonic perforation in a 12-year-old girl. Although it is common practice at the time of shunt revision to leave a retained distal catheter in the peritoneal cavity, we suggest this can result in perforation of solid as well as hollow viscera.