ACR Appropriateness Criteria® Urinary Tract Infection-Child: 2023 Update.

Urinary tract infection (UTI) is a frequent infection in childhood. The diagnosis is usually made by history and physical examination and confirmed by urine analysis. Cystitis is infection or inflammation confined to the bladder, whereas pyelonephritis is infection or inflammation of kidneys.

ACR Appropriateness Criteria® Soft Tissue Vascular Anomalies: Vascular Malformations and Infantile Vascular Tumors (Non-CNS)-Child.

Soft tissue vascular anomalies may be composed of arterial, venous, and/or lymphatic elements, and diagnosed prenatally or later in childhood or adulthood. They are divided into categories of vascular malformations and vascular tumors. Vascular malformations are further divided into low-flow and fast-flow lesions.

Highlights 2023.

publishes novel research and technical developments in cardiac, thoracic, and vascular imaging. The journal published many innovative studies during 2023 and achieved an impact factor for the first time since its inaugural issue in 2019, with an impact factor of 7.0.

One children's hospital planning and development process to adhere to the FDA recommendation that babies and young children undergo thyroid function testing after receiving an injection of iodine-containing contrast media for medical imaging.

The United States (US) Food and Drug Administration (FDA) has issued multiple statements and guidelines since 2015 on the topic of thyroid function testing in babies and children through 3 years old after receiving iodinated contrast media for medical imaging exams. In April 2023, the FDA adjusted this recommendation to target babies and young children younger than 4 years of age who have a history of prematurity, very low birth weight, or underlying conditions which affect thyroid gland function, largely in response to solid arguments from expert statements from the American College of Radiology (ACR) which is endorsed by the Society for Pediatric Radiology (SPR), Pediatric Endocrinology Society (PES), and the Society for Cardiovascular Angiography & Intervention (SCAI). Herein we describe our approach and development of a clinical care guideline along with the steps necessary for implementation of the plan including alterations in ordering exams requiring iodinated contrast media, automatic triggering of lab orders, reporting, and follow-up, to address the 2022 FDA guidance statement to monitor thyroid function in children after receiving iodinated contrast media.

Four-dimensional fetal cardiac imaging in a cohort of fetuses with suspected congenital heart disease.

Background: Fetal cardiac magnetic resonance imaging (MRI) requires high spatial and temporal resolution and robustness to random fetal motion to capture the dynamics of the beating fetal heart. Slice-to-volume reconstruction techniques can produce high-resolution isotropic images while compensating for random fetal motion.

Objective: The objective of this study was to evaluate image quality for slice-to-volume reconstruction of four-dimensional balanced steady-state free precession (bSSFP) imaging of the fetal heart.

ACR Appropriateness Criteria® Crohn Disease-Child.

Crohn disease is an inflammatory condition of the gastrointestinal tract with episodes of exacerbation and remission occurring in children, adolescents, and adults. Crohn disease diagnosis and treatment depend upon a combination of clinical, laboratory, endoscopic, histological, and imaging findings. Appropriate use of imaging provides critical information in the settings of diagnosis, assessment of acute symptoms, disease surveillance, and therapy monitoring.

Contribution of fetal magnetic resonance imaging in fetuses with congenital heart disease.

Background: Increasing evidence supports an association among congenital heart disease (CHD), structural brain lesions on neuroimaging, and increased risk of neurodevelopmental delay and other structural anomalies. Fetal MRI has been found to be effective in demonstrating fetal structural and developmental abnormalities.

Objective: To determine the contribution of fetal MRI to identifying cardiovascular and non-cardiovascular anomalies in fetuses with CHD compared to prenatal US and fetal echocardiography.

Radial sequences and compressed sensing in pediatric body magnetic resonance imaging.

Magnetic resonance imaging (MRI) is often an ideal imaging modality for children of any age for any anatomy and for many pathologies. MRI sequences can be prescribed to produce high-resolution images of anatomical structures, characterize tissue composition, and detect physiological states and organ function. Shortening imaging sequences in any manner possible has been a topic of research and development in MRI since its emergence.

Data Quality Assessment for Super-Resolution Fetal Brain MR Imaging: A Retrospective 1.5 T Study.

Background: Super-resolution is a promising technique to create isotropic image volumes from stacks of two-dimensional (2D) motion-corrupted images in fetal magnetic resonance imaging (MRI).

Purpose: To determine an acquisition quality metric and correlate that metric with radiologist perception of three-dimensional (3D) image quality.

Study Type: Retrospective.

Imaging of fetal brain tumors.

Congenital brain tumors, defined as those diagnosed prenatally or within the first 2 months of age, represent less than 2% of pediatric brain tumors. Their location, prevalence and pathophysiology differ from those of tumors that develop later in life. Imaging plays a crucial role in diagnosis, tumor characterization and treatment planning.

ACR Appropriateness Criteria® Vomiting in Infants.

Vomiting in infants under the age of 3 months is one of the most common reasons for parents to seek care from their doctor or present to an emergency room. The imaging workup that ensues is dependent on several factors: age at onset, days versus weeks after birth, quality of emesis, bilious or nonbilious vomiting, and the initial findings on plain radiograph, suspected proximal versus distal bowel obstruction. The purpose of these guidelines is to inform the clinician, based on current evidence, what is the next highest yield and most appropriate imaging study to pursue a diagnosis.

ACR Appropriateness Criteria® Antenatal Hydronephrosis-Infant.

Antenatal hydronephrosis is the most frequent urinary tract anomaly detected on prenatal ultrasonography. It occurs approximately twice as often in males as in females. Most antenatal hydronephrosis is transient with little long-term significance, and few children with antenatal hydronephrosis will have significant obstruction, develop symptoms or complications, and require surgery.

ACR Appropriateness Criteria® Pneumonia in the Immunocompetent Child.

Pneumonia is one of the most common acute infections and the single greatest infectious cause of death in children worldwide. In uncomplicated, community-acquired pneumonia in immunocompetent patients, the diagnosis is clinical and imaging has no role. The first role of imaging is to identify complications associated with pneumonia such as pleural effusion, pulmonary abscess, and bronchopleural fistula.

CT Findings of Pediatric Handlebar Injuries.

Direct bicycle handlebar injuries are a significant cause of chest and abdominal trauma and morbidity in the pediatric population. However, these injuries have been underemphasized. While blunt abdominal trauma has been described well, the literature is limited in reviewing trauma imaging specifically related to direct handlebar injuries in the pediatric population.

Neonatal Neuroimaging.

Significant advances in the field of neonatal imaging has resulted in the generation of large complex data sets of relevant information for routine daily clinical practice, and basic and translational research. The evaluation of this data is a complex task for the neonatal imager who must distinguish normal and incidental findings from clinically significant abnormalities which are often adjunctive data points applicable to clinical evaluation and treatment. This review provides an overview of the imaging manifestations of disease processes commonly encountered in the neonatal brain.

ACR Appropriateness Criteria Developmental Dysplasia of the Hip-Child.

Developmental dysplasia of the hip (DDH) is the most common hip pathology in infants. Although its exact pathophysiology remains incompletely understood, its long-term prognosis depends not only on the severity of the dysphasia, but also on the timely implementation of appropriate treatment. Unrecognized and untreated hip subluxations and dislocations inevitably lead to early joint degeneration while overtreatment can produce iatrogenic complications, including avascular necrosis of the femoral head.