Prevalence of intrarenal reflux in pediatric patients on contrast-enhanced voiding urosonography.

Background: Intrarenal reflux may be seen with vesicoureteral reflux (VUR) when contrast from the pelvocalyceal system extends into tubules in the parenchyma. Because intrarenal reflux has been associated with scarring, detecting intrarenal reflux may influence management to avoid renal damage.

Objective: Our objective was to evaluate the prevalence of intrarenal reflux identified on contrast-enhanced voiding urosonography (ceVUS) and its association with sex, age, grade of VUR, location in kidney and stage of bladder filling or voiding.

Pediatric Hodgkin Lymphoma, Version 3.2021.

Hodgkin lymphoma (HL) is a highly curable form of cancer, and current treatment regimens are focused on improving treatment efficacy while decreasing the risk of late effects of treatment. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for pediatric HL provide recommendations on the workup, diagnostic evaluation, and treatment of classic HL, including principles of pathology, imaging, staging, systemic therapy, and radiation therapy. This portion of the NCCN Guidelines focuses on the management of pediatric classic HL in the upfront and relapsed/refractory settings.

Assessment of distal ureteral and ureterovesical junction visualization on contrast-enhanced voiding urosonography.

Background: Contrast-enhanced voiding urosonography (CEVUS) uses intravesically administered microbubble contrast to detect vesicoureteral reflux (VUR) and urethral anomalies with ultrasound. Multiple studies have suggested CEVUS can replace voiding cystourethrogram (VCUG) as a radiation-free alternative. Analysis of the ureterovesical junction and ureters on VCUG documenting the ureterovesical junction position, ureteral duplication, periureteral diverticula and ureteroceles is important as anatomical variations may affect management and surgical approach.

Alvarado Scores Predict Additive Value of Magnetic Resonance Imaging in Workup of Suspected Appendicitis in Children.

Background: The presentation of appendicitis in pediatrics is variable, and diagnostic imaging is often used. Magnetic resonance imaging (MRI) is replacing computed tomography in some centers, particularly after a nondiagnostic ultrasound (NDUS). Nonetheless, MRI is not widely used in this setting because of cost, procedure time, institutional capacity, and high rates of negative scans.

Evaluation of a pediatric fluoroscopy training module to improve performance of upper gastrointestinal procedures in neonates with bilious emesis.

Background: Life-threatening midgut volvulus usually occurs in infants with malrotation and requires rapid diagnosis and surgical treatment to prevent bowel necrosis and death. However, because of the low frequency of upper gastrointestinal studies performed in infants younger than 1 month, many diagnostic radiology residents finish their residency training having limited or no opportunity to perform or observe an upper gastrointestinal (GI) series for evaluation of bilious emesis in a neonate.

Objective: To determine whether adding simulated upper GI series on neonates with bilious emesis to the curriculum improves residents' skill and accuracy in diagnosing midgut volvulus.

Upper gastrointestinal fluoroscopic simulator for neonates with bilious emesis.

Prompt diagnosis of malrotation and midgut volvulus in infants with bilious emesis is critical. However because of the limited frequency of pediatric upper gastrointestinal (UGI) fluoroscopic procedures in neonates, many diagnostic radiology residents complete their training never having seen or performed a UGI on a baby for evaluation of malrotation and midgut volvulus. A UGI simulation model for infants with bilious emesis was created to supplement the hands-on fluoroscopic experience of residents in training.

Fluoroscopy screen time during contrast enema for the evaluation and treatment of intussusception.

Objective: The objective of this study was to describe fluoroscopy screen time (FST) for children undergoing contrast enema (CE) for suspected intussusception.

Methods: This is a single-center, retrospective cohort study of children younger than 7 years examined for intussusception by CE. We reviewed medical records for demographics, radiographic results, and FST.

Factors influencing subspecialty choice among radiology residents: a case study of pediatric radiology.

Purpose: Persistent workforce shortages exist in some radiology subspecialties. Residents' motivations for selecting particular fellowships, as well as their perceptions of the subspecialty fields, heavily influence the supply of new radiologists to these areas. The authors investigated the factors residents consider most important in subspecialty choice, fellowship choice patterns between 1999 and 2008, and changes that might attract residents to one particular shortage field: pediatric radiology.

Contrast enema in children with Henoch-Schönlein purpura.

Background/purpose: There are references in the medical literature that Henoch-Schönle purpura (HSP) and abdominal pain are contraindictions to performing contrast enemas (CEs) for diagnosis and possible reduction of intussusceptions. We investigated the safety of performing CEs in patients with abdominal pain and HSP.

Methods: A retrospective chart review and literature search were conducted.

Pancreas and biliary system: imaging of developmental anomalies and diseases unique to children.

The focus of this article is on the development of the pancreas and biliary system, with a review of the most common congenital anomalies affecting the pancreas and biliary tree, including pancreas divisum, annular pancreas, congenital shortening of the pancreas, and choledochal cysts. Additionally, biliary atresia and pancreatoblastoma--both diseases of the pancreas and biliary system that almost exclusively affect children--are considered, with a discussion regarding the clinical presentation and imaging appearances of these disorders.